Sources and determinants of social support for caregivers of persons with AIDS

Endocrine studies of captive strepsirrhine primates suggest that physical environment and social factors mediate inter-individual variations in testicular function and serum testosterone (sT) in males. While these studies have made major contributions to our understanding of the individual proximate mechanisms influencing androgen activity in male strepsirrhines, none have investigated how these mechanisms work coincidentally in free-ranging populations. In this study we used fecal steroid analysis to examine androgen-behavior interactions associated with reproduction in free-ranging male Propithecus verreauxi. Behavioral and hormone data were collected from two social groups during the 1990-91 and 1991-92 breeding seasons at Beza Mahafaly, Madagascar. Solid phase and radioimmunoassay techniques were used to quantify testosterone (T) in 105 desiccated fecal samples collected weekly from seven males. Results suggest that 1) solid phase extraction and radioimmunoassay techniques were reliable and accurate methods for quantifying T in sifaka feces; 2) fecal T (fT) elevations spanned a minimum of 4 months, peak levels occurring 1 month prior to the January onset of the breeding season; 3) fecal T concentrations were influenced by developmental factors and, among mature males, social factors associated with rank, intergroup aggression, and group instability.     

Stress, social support, and psychological distress among the Chinese elderly

This study examined the relationships among stress, social support, and depressive symptoms with data provided by a large representative sample (N = 2,721) of older adults who live in the People's Republic of China. Many Western investigators believe that elderly people respond to stressful experiences by mobilizing assistance from their significant others. However, recent American studies suggest that this may not always be true, and that when certain stressors arise, older adults may actually receive less support from significant others. The purpose of our study was to evaluate these competing views in a culturally diverse setting. The findings reveal that both perspectives have something to offer and that financial strain (i.e., one kind of stressor) may increase some kinds of assistance (i.e., economic support) at the same time that it erodes other types of support (e.g., emotional support).     

Stress, maternal distress, and children's adjustment following immigration: The buffering role of social support.

This study examined, in the context of a stress-buffering model, the relationship of certain family level variables to children's adjustment after immigration. Immigrant Chinese mothers from Hong Kong completed questionnaires regarding postmigration stress, personal distress, perceived social support, and their child's adjustment. Another adult also provided child behavior ratings. Analyses revealed that, for boys, family stress and maternal distress were significant predictors of child problems and that maternal support buffered the association between family stress and child problems. Contrary to expectation, the relationship between maternal distress and boys' problems was stronger at higher levels of maternal support. For families of girls, although there were significant relationships between the predictors and child behavior, no stress buffering was evident. Cultural explanations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality, social support, and psychological distress in later life.

A conceptual model was developed to address 2 issues that have received relatively little attention in the social support literature. First, an attempt was made to assess the interrelationships among 3 types or dimensions of supportive social relations. In addition, the impact of selected psychological and social factors on social support use was examined. Findings from a nationwide survey of older adults in the United Kingdom suggest that social contact tends to increase the amount of received support, and received support in turn tends to bolster perceptions of support availability in the future (i.e., anticipated support). With regard to the second issue, social roles (especially marital status) and social extraversion emerged as potentially important correlates of social support use in later life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, social support, and the buffering hypothesis.

Examines whether the positive association between social support and well-being is attributable more to an overall beneficial effect of support (main- or direct-effect model) or to a process of support protecting persons from potentially adverse effects of stressful events (buffering model). The review of studies is organized according to (1) whether a measure assesses support structure (the existence of relationships) or function (the extent to which one's interpersonal relationships provide particular resources) and (2) the degree of specificity (vs globality) of the scale. Special attention is given to methodological characteristics that are requisite for a fair comparison of the models. It is concluded that there is evidence consistent with both models. Evidence for the buffering model is found when the social support measure assesses the perceived availability of interpersonal resources that are responsive to the needs elicited by stressful events. Evidence for a main effect model is found when the support measure assesses a person's degree of integration in a large social network. Both conceptualizations of social support are correct in some respects, but each represents a different process through which social support may affect well-being. Implications for theories of social support processes and for the design of preventive interventions are discussed. (4 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, social support, and college adjustment among Latino students

We examined the expression of an oncofetal 65-kDa phosphoprotein, termed p65, in patients with lymphocytic and granulocytic leukemia. This protein was previously identified in rat fetal tissues and in epithelial cancers of rat and human origin. Using the anti-p65 monoclonal antibodies MB2 and MF11 in a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA), we analyzed the expression of the protein in sera of 80 normal, healthy controls and in 61 patients with benign, nonneoplastic diseases. We established that the upper level of normal p65 concentration is 115 U/ml p65 (mean plus two standard deviations above the mean in a control group). We also analyzed p65 levels in sera of 71 patients with leukemia in different stages of development. The level of p65 was well above normal in 95% of acute lymphocytic leukemia (ALL; 19 cases), 83% of acute myeloblastic leukemia (AML; 23 cases), 37% of chronic lymphocytic leukemia (CLL; 19 cases), and 30% of chronic myelogenous leukemia (CML; 10 cases). MB2 monoclonal antibodies were used for immunocytochemical staining of isolated lymphocytes from normal peripheral blood and from blood of leukemic patients (in 12 CLL patients, the p65 positivity was 83%, in 2 ALL patients, 100%, and in 4 AML patients, 75%). Our data suggest that p65 protein may be of use as a tumor marker in leukemia.     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meeting the social service needs of persons with AIDS: hospices' response

A national sample of 148 directors of hospice social service departments (or persons most familiar with the delivery of social services in the hospice) participated in an exploratory study investigating the effects of the acquired immune deficiency syndrome (AIDS) epidemic on the delivery of hospice social services. Findings suggest, as does the literature, that the psychosocial needs of persons dying from AIDS present different challenges than those of traditional hospice patients. Furthermore, the results indicate the need for greater collaborative efforts among community agencies as well as specific and ongoing training for staff and volunteers who work with persons with AIDS (PWAs). Implications for the delivery of hospice social services to this population are discussed.     

Life stress, social support, and self-esteem in an elderly population.

Findings in previous studies of the stress-buffering properties of social support have been erratic. This study suggests that at least part of the reason for those inconclusive findings may be that researchers are using oversimplified models of the stress process and limited statistical approaches to assess the effects. The findings in this study indicate that social support (a) helps to reduce the deleterious effects of stress on emotional disorder primarily by bolstering the self-esteem of older adults and (b) affects psychological well-being only indirectly through self-esteem. Two distinct approaches to the statistical estimation of stress-buffering effects are also examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, social support and pregnancy outcome: a reassessment based on recent research

We present an assessment of studies published in the last decade that consider the relationship of stress and social support to preterm delivery or fetal growth retardation. Included in the review are all reports on the direct effects of stressors or psychological distress; the indirect effects of stressors or distress through health behaviours such as smoking; and the direct and buffering effects of social support. Although an important stimulus for recent stress research has been the attempt to explain racial and social class differences in birth outcome, the recent data show that stressful life events during pregnancy, though more common in disadvantaged groups, do not increase the risk of preterm birth. In contrast, intimate social support from a partner or family member appears to improve fetal growth, even for women with little life stress. Questions unanswered by the research to date are whether elevated levels of depressive symptoms affect pregnancy outcome, either directly or by encouraging negative health behaviours, and whether chronic (vs. acute) stressors are harmful. Additional research is also needed to determine whether psychosocial factors interact with specific clinical conditions to promote adverse pregnancy outcomes. Focusing on intimate support and how it benefits pregnancy outcome could lead to the design of more effective interventions.     

Influence of functional impairment and social support on depressive symptoms in persons with diabetes.

Tested the hypothesis that, among patients with higher levels of illness-related impairment, adequate social support would act as a buffer against depression. 158 Ss (aged 17–78 yrs) with insulin-dependent diabetes mellitus completed the Beck Depression Inventory, a health status measure, and 2 measures of social support. Depressive symptoms correlated positively with functional impairment and negatively with adequacy of social support. In addition, social support moderated depression in the face of greater impairment such that, among Ss who reported the most illness-related functional disabilities, adequate support provided a relative protection from depression. Individuals with inadequate support seem to be most at risk for depression when disability related to illness increases. (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)     

Stress, social support, and substantiated maltreatment in the second and third years of life

OBJECTIVE: The purpose of this research was to determine whether risk factors for a maltreatment report in the first year of life, especially the interaction of life event stress and social support, persist into the second and third years of life. METHOD: Predominantly low income mothers who had been interviewed shortly after the birth of infants in a longitudinal cohort were re-interviewed around the infants' first birthdays, and reports to North Carolina's Central Registry of Child Abuse and Neglect were tracked for substantiated maltreatment reports. RESULTS: Variables significantly associated with a substantiated maltreatment report in the second or third year of life (p < .01) were first year maltreatment reports and participation in Medicaid. Three interactions between a stressful life event indicator variable and a social support indicator variable were significant predictors of substantiated second or third year reports (p < .05). CONCLUSIONS: Even in the presence of significant risk factors from the first year of life, life event stress can increase the risk of a substantiated maltreatment report in the second or third years of life, but social support may moderate the effect of life events.     

The relationship between social support and psychological distress among Hispanic elders in Miami, Florida.

This study compared 5 psychological models of the relationship between social support (SS) and behavioral health. These theoretical models, which have garnered some level of prior empirical support, were as follows: (a) main effects, (b) buffering effects, (c) social exchange, (d) equity, and (e) protective health outcomes of providing SS. A population-based sample of 273 community-dwelling Hispanic elders drawn from East Little Havana, Florida (ages 70-100 years old; 86% Cuban) completed self-report measures of SS, financial strain, and psychological distress (PD). Hierarchical multiple regression analyses were used to test the competing SS models. Results indicated that satisfaction with received SS was, as specified in the main-effects model, associated with lower PD, whereas received SS was unexpectedly associated with heightened PD. Reciprocal exchanges of SS (equity model) or exchanges where Hispanic elders provided more SS than they received (protective health outcomes of providing SS model) were also associated with lower PD. The feasibility of a 6th model in which the effects of SS are contingent upon the elder's preexisting PD level is proposed. Limitations, implications, and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The overlapping contributions of attachment orientation and social support in predicting life-events distress.

Attachment anxiety, attachment avoidance, and perceived social support are examined as predictors of life-events distress. Clients at initial intake to an addiction treatment centre and university students in their graduating year were administered measures of attachment orientation, social support, and the experience of distressing life events. Hypotheses were tested across different categories of distressing life events (overall distress, bereavement, relationship dissolution, crime victimization, and severe accidents). We found that attachment anxiety and attachment avoidance have varying predictive utility for distress, depending on the type of event. Social support did not account for variance beyond attachment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Provision of psychotherapy for a statewide population of Medicaid beneficiaries with schizophrenia.

This study uses 1,995 Medicaid-paid claims from Georgia to examine factors influencing the provision of psychotherapy services to patients with schizophrenia. Measures of services included individual and group psychotherapy and were derived using the Physician's Current Procedural Terminology, 4th edition (CPT-4) codes. Approximately one in four patients received psychotherapy during the study period. When controlling for other factors, psychotherapy use was less likely for African American than White patients and more likely for women, those with comorbid substance abuse, and those with severe physical comorbidities. Compared with those not treated with an antipsychotic, those being treated with typical antipsychotics did not differ in psychotherapy use, but those treated with atypical antipsychotics were significantly more likely also to be receiving psychotherapy. Among psychotherapy users, individual psychotherapy alone was most common. Compared with those receiving only individual psychotherapy, the probability of receiving additional group therapy or group therapy alone was elevated for African American patients, those in metropolitan areas, and those with comorbid substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)