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“Chronic social stress and psychological distress”

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Thesis submitted in partial fulfilment of the requirements for the degree Master of Philosophy in Health Promotion, University of Bergen 2004.
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Chronic social stress is strongly related to psychological distress in vulnerable groups such as the frail elderly and ill people. Little, however, is known about these phenomena in the general population. The validity and reliability of a new brief measure, the Bergen Social Relationships Scale (BSRS), were investigated in a Norwegian county; the prevalence of chronic social stress was measured using the BSRS, and the associations of chronic social stress and social support with three measures of psychological distress were investigated. Respondents with high BSRS scores had experienced longstanding, important interpersonal relationship problems rather than fleeting stressful incidents. Women reported higher levels of chronic social stress, 60% reporting positively on at least one of the six BSRS items, compared with 50% among men. Social support was negatively and significantly associated with various measures of psychological distress. Chronic social stress was positively and significantly associated with psychological distress. These effects were independent of one another. No buffering effect of social support on social stress was observed. The present data support the importance of positive social ties to health, but suggest that social stress is an independent aspect of social environment with regard to health. If social support and social stress have direct and independent effects on mental health, as the present results indicate, intervention on the one will not necessarily modify the other. Intervention programmes may need to consider explicitly both the lighter and the darker sides of social relationships in building environments that support mental health.
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Examines 3 ways in which the social environment is implicated in chronic stress processes. First, the variety of social sources of chronic stress are described. Second, the author shows how the social environment can moderate, or alter, the impact of chronic stressors by mitigating or exacerbating people's responses to them. Finally, the author illustrates how enduring and undesirable changes in the social environment, which often result from stressful life events, can mediate, or explain, the effects of major life events on health and well-being. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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It was hypothesized that women are more vulnerable to depressive symptoms than men because they are more likely to experience chronic negative circumstances (or strain), to have a low sense of mastery, and to engage in ruminative coping. The hypotheses were tested in a 2-wave study of approximately 1,100 community-based adults who were 25 to 75 years old. Chronic strain, low mastery, and rumination were each more common in women than in men and mediated the gender difference in depressive symptoms. Rumination amplified the effects of mastery and, to some extent, chronic strain on depressive symptoms. In addition, chronic strain and rumination had reciprocal effects on each other over time, and low mastery also contributed to more rumination. Finally, depressive symptoms contributed to more rumination and less mastery over time.
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A framework for hypothesis testing and power analysis in the assessment of fit of covariance structure models is presented. We emphasize the value of confidence intervals for fit indices, and we stress the relationship of confidence intervals to a framework for hypothesis testing. The approach allows for testing null hypotheses of not-good fit, reversing the role of the null hypothesis in conventional tests of model fit, so that a significant result provides strong support for good fit. The approach also allows for direct estimation of power, where effect size is defined in terms of a null and alternative value of the root-mean-square error of approximation fit index proposed by J. H. Steiger and J. M. Lind (1980). It is also feasible to determine minimum sample size required to achieve a given level of power for any test of fit in this framework. Computer programs and examples are provided for power analyses and calculation of minimum sample sizes. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The goals of this study were to (i) examine the association of social support and strain with psychological well-being and health, (ii) investigate whether these associations depended on relationship-type (partner, family, friend), (iii) examine the buffering effects of support on strain (both within and across relationship-type), and (iv) test the extent to which these associations differed by age and sex. The sample contained 2,348 adults (55% male) aged 25 to 75 years (M � 46.3), who were married or cohabitating. Positive and negative social exchanges were more strongly related to psychological well- being than to health. For both sexes, partner support and strain and family support were predictive of well-being measures; partner strain was also predictive of health prob- lems. However, family strain was predictive of well-being and health outcomes more often for women. Further, while we did find evidence that supportive networks could buffer the detri- mental effects of strained interactions, friends and family served a buffering role more often for women than for men.
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the most basic themes running throughout [the chapter] are the 4 issues of flexibility, specificity, differentiation, and disaggregation of stress concepts (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Research has consistently indicated that health-related stressors affect depressive symptoms largely to the extent that they restrict routine activities. Beyond the impact of illness severity, psychosocial variables (age, income adequacy, social support, and personality) also contribute to restricted activities. Moreover, after controlling for illness severity and psychosocial factors, activity restriction explains significant portions of the variance in symptoms of depression. Thus, depressed affect is at least partially a function of restricted activities. Further specifying the processes through which activities come to be restricted should not only provide clues about points of intervention but also aid in early identification of individuals at risk for poor adaptation. In addition to treating illness symptoms and depression, interventions can be designed to increase participation in routine activities, even in the presence of illness symptoms, depression, or both. Implications of activity restriction studies for intervention are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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attempt to integrate transactional stress theory with social cognitive theory / regard generalized self-efficacy as one of the personal resource factors that counterbalance taxing environmental demands in the stress appraisal process / stress can be cognitively appraised as either a challenge, threat, or harm/loss / subjects who were confronted with difficult tasks under time pressure received fictitious performance feedback / conclude that dispositional self-efficacy not only facilitates coping with stress but is already operating at an earlier phase of the stress process, namely at the cognitive appraisal stage (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The current study investigates the relationship between social support and mental and physical health. Results indicate that poor functional support (or quality of support) is related to physical health problems while structural support (or social network size) is not. Moreover, although both poor functional and structural support are related to depression and anxiety, functional support is more strongly related to these outcome variables, the strongest relationship being associated with depression. Depression and hostility are also related to social isolation, although the relationship is again stronger for depression. The results suggest that the quality of social relationships is more important than quantity for optimal mental and physical health. The clinical relevance of these findings is that the quality of social support in the lives of individuals is central to recovery and should be addressed in medical and mental health treatment planning whenever it is an etiological or maintaining factor.
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The following paper reports an investigation of the relationship between various life event measures and some important measures of anxiety and its cognitive correlates. The results suggest that (i) measures of both trait anxiety and worrying are significantly related to measures of daily hassles, but are unrelated to other life event measures such as negative life events or world events, and (ii) both the tendency to interpret events as threatening and the tendency to seek out threat-relevant information (‘monitoring’) were significantly related to measures of daily hassles but unrelated to other life event measures. These results suggest that the relationship between daily hassles and trait anxiety extends to some of the important cognitive phenomena associated with anxiety, and they provide a means of conceptualizing the relationship between daily hassles and trait anxiety as an interactive one.
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The association between marital dissatisfaction at baseline and 12-month incidence of major depressive episode (MDE) was examined in a community sample of married individuals from the New Haven Epidemiologic Catchment Area program (N = 904) who did not meet criteria for MDE at baseline. Results indicate that marital dissatisfaction was associated with increased incidence of MDE, with a significant risk ratio of 2.7 and an attributable risk of 29.5%. Thus, dissatisfied spouses were nearly 3 times more likely than nondissatisfied spouses to develop an MDE during the year, and nearly 30% of the new occurrences of MDE were associated with marital dissatisfaction. The association between marital dissatisfaction and risk of MDE (a) remained significant when controlling for demographics and depression history and (b) was not moderated by sex or by depression history. Findings suggest that marital dissatisfaction may be etiologically related to major depression.
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By extending earlier stress-resistance research with a 1-year time lag, findings with 254 adults show that adaptive personality characteristics and positive family support operate prospectively over 4 years in predicting reduced depression, even when prior depression is controlled. By strengthening knowledge about the determinants and mediational role of coping, the results demonstrate in a 2-group LISREL analysis that the pattern of predictive relations differs under high and low stressors. Under high stressors, personal and social resources relate to future psychological health indirectly, through more adaptive coping strategies. Under low stressors, these resources relate directly to psychological health. The results support the idea that such resources play a causal role in maintaining psychological health, and they suggest the potential for a general, adaptively oriented framework applicable to adjustment under both high and low stressors.
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More than 200 published studies from most medical settings worldwide have reported experiences with the Hospital Anxiety and Depression Scale (HADS) which was specifically developed by Zigmond and Snaith for use with physically ill patients. Although introduced in 1983, there is still no comprehensive documentation of its psychometric properties. The present review summarizes available data on reliability and validity and gives an overview of clinical studies conducted with this instrument and their most important findings. The HADS gives clinically meaningful results as a psychological screening tool, in clinical group comparisons and in correlational studies with several aspects of disease and quality of life. It is sensitive to changes both during the course of diseases and in response to psychotherapeutic and psychopharmacological intervention. Finally, HADS scores predict psychosocial and possibly also physical outcome.
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The occurrence and predictors of post-traumatic stress symptoms 1 year after a burn injury were assessed in a large prospective sample (N = 172). Participants completed a self-report post-traumatic stress symptom checklist at 3 time points: within 24 hours of admission to a burn center, 1 month after the injury, and 1 year after the injury. A notable number of participants had a range of post-traumatic stress symptoms both at 1 month and at 1 year after the burn injury. More than half of the sample reported recurrent intrusive recollections of the burn injury at 1 month and at 1 year. Other commonly endorsed symptoms were sleep disturbance, avoidance of thoughts or feelings associated with the burn, and distress at reminders of the burn. The number of post-traumatic stress symptoms endorsed at 1 month was the only significant predictor of post-traumatic stress symptoms at 1 year. These results suggest that it is common for patients to have some post-traumatic symptoms 1 year after a burn injury and that early experiences of post-traumatic stress symptoms may be associated with the development or maintenance of post-traumatic stress disorder. We recommend that burn care professionals identify and intervene with patients who have clinically significant distress as a result of their burn injuries.
Article
Health problems of the urban poor have been attributed to psychosocial effects of environmental stress. Testing such models requires an ability to measure neighborhood characteristics that make life stressful. The City Stress Inventory (CSI) uses self-report to assess perceived neighborhood disorder and exposure to violence. Data from an interracial sample of urban adolescents show the CSI to be internally consistent, stable, and correlated with census indices of social disadvantage. Validity for stress research is indicated by correlations with trait depression, anger, hostility, self-esteem, and mood changes during a debate with an unfamiliar peer. The CSI can be completed by persons with an 8th-grade education.
Article
The aim of this study was to examine associations between functional ability to perform basic activities of daily living (ADL) functions (feeding, continence, going to the toilet, transferring from bed to chair, dressing and bathing), social contacts with family and friends/neighbours and emotional and social loneliness. A quantitative research approach, using a survey design, was performed. The sample comprised 113 subjects aged 65-101 years, living in nursing homes. Data were gathered through structured interviews by using the following measures: the modified Katz Index of ADL, the Revised Social Provisions Scale (SPS), and Family and Friendship Contacts Scale. Descriptive statistics, factor analyses, multiple correlation analyses and multiple regression analyses were used. Data showed a statistically significant relationship between dependence on the environment in carrying out ADL and low level of social loneliness. Likewise, high frequencies of social contact with sons, daughters and grandchildren had a statistically significant effect on low level of social loneliness. A confirmatory factor analysis (varimax rotation, eigenvalue 1.0) was employed to explore the two predefined dimensions (attachment and social integration) of the SPS. The results confirmed, to a very high degree, the two dimensions of the Weiss Model. Reliability (internal consistency), measured by Cronbach alpha, was 0.85 and 0.92, for attachment and social integration respectively. Based on this analysis, dependence in ADL function is important for a low level of social loneliness. From the present study it is concluded that ADL (feeding, continence, going to the toilet, transferring from bed to chair, dressing and bathing) and contact with a social network have a statistical effect on a low level of social loneliness. Hence, such associations may be of significance in nursing intervention and may influence the well-being of residents in nursing homes in different stages of life.
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