Lecture+7.+Social+support.+4-20-16.+PDF+VERSION.pdf -...

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Unformatted text preview: SOCIAL SUPPORT APRIL 21 SPRING 2016 U C DAV I S OVERVIEW • 1) Social support: definition and types • 2) Social support and illness • 3) Biopsychosocial pathways • 4) What kinds of social support are most effective? • 5) Social support interventions 1) WHAT IS SOCIAL SUPPORT? • Information from others that one is: – Loved and cared for – Esteemed and valued – Part of a network of communication and mutual obligations • Helps reduce stress, cope better, and live positively - can come from parents, spouse/partner, other relatives, friends, social and community contacts, devoted pet - people with social support experience less stress when they confront a stressful experience, cope with it more successfully, and even experience positive life events more positively - not having social support is stressful - elderly, recently widowed, and victims of sudden, severe, uncontrollable life events - people who are chronically shy, or those who anticipate rejection by others TYPES OF SOCIAL SUPPORT Material support • Provision of tangible assistance • Services, financial assistance, or goods Informational support • Providing support through information Emotional support • Reassuring someone that they are important and cared for Invisible support • Helping someone without him or her being aware of it 2) EFFECTS OF SOCIAL SUPPORT ON ILLNESS • Social support: – Lowers the likelihood of illness – Speeds up recovery – Reduces the risk of mortality – Encourages individuals to use health services and stick to their medical regimens – Can lead to bad health habits - peer group smokes, drinks heavily, or takes drugs - when a lot of social contact is coupled with stress - risk of minor illnesses such as colds or flus may actually increase because of contagion through social network SOCIAL RELATIONSHIPS AND MORTALITY • Recent meta-analysis by Holt-Lunstad and Smith (2012) suggests that social relationships are an important predictor of longevity/mortality • The effect size is comparable to that of some health behaviors (smoking) and stronger than that of other health behaviors (physical activity) or environmental factors (air pollution) Holt-Lunstad & Smith (2012, Social and Personality Psychology Compass) MARITAL SATISFACTION AND WEIGHT • 169 newlywed couples followed for 4 years • Tested two competing models: – Health regulation model: supportive relationships regulate healthy behaviors Prediction: happy marriage healthier weight profile over time – Mating market model: weight maintenance is motivated by wanting to attract a mate Prediction: unhappy marriage healthier weight profile over time Meltzer et al. (Health Psychology, 2013) 3) BIOPSYCHOSOCIAL PATHWAYS • Social support has positive effects on the cardiovascular, endocrine, and immune systems – Lowers physiological and neuroendocrine responses to stress – Decreases cortisol responses to stress – Better immune functioning – Modifies brain’s responses to stress ROMANTIC PARTNERS AS STRESS BUFFERS IN ADULTHOOD Kirschbaum et al. (1995, Psychosomatic Medicine) ROMANTIC PARTNERS AS STRESS BUFFERS IN ADULTHOOD Ditzen et al., (2007, Psychoneuroendocrinology) PARENTAL BUFFERING OF CORTISOL STRESS RESPONSES DURING CHILDHOOD AND ADOLESCENCE Cortisol Responses in Adolescents 5.00 5.00 4.50 4.50 4.00 Parent 3.50 Stranger 3.00 Day 2 (rest) 2.50 Cortisol (nmol/L) Cortisol (nmol/L) Cortisol Responses in Children 2.50 1.50 1.50 40 min 60 min Day 2 (rest) 3.00 2.00 20 min Stranger 3.50 2.00 0 Parent 4.00 0 Hostinar et al. (2015, Developmental Science) 20 min 40 min 60 min Early-life Social Experiences and Stress Buffering Post-institutionalized children 4.0 4.0 3.5 3.5 3.0 2.5 NA Parent 2.0 NA Stranger Day 2 (rest) 1.5 1.0 Estimated Cortisol nmol/L Estimated Cortisol nmol/L Non-Adopted Children 3.0 2.5 0.0 0.0 40 min 60 min Day 2 (rest) 1.0 0.5 20 min PI Parent 1.5 0.5 0 PI Stranger 2.0 0 20 min 40 min Hostinar et al. (2015, Developmental Psychology) 60 min WHAT IS THE MECHANISM? • Some evidence from prairie voles it may be oxytocin • Oxytocin is a neuropeptide involved in affiliation, social contact/proximity, generosity, reproductive behaviors • Oxytocin video notes: SOCIAL RELATIONSHIPS AND IMMUNE FUNCTION • Sheldon Cohen’s studies have linked social network size and diversity to protection against colds Social network diversity SOCIAL SUPPORT CAN REDUCE PAIN AND ACTIVATE REWARD REGIONS IN THE BRAIN • Neuroimaging study of 15 individuals in the first 9 months of a romantic relationship • Subjected to thermal pain and randomly assigned to one of three conditions: – View picture of romantic partner – View picture of stranger – Word-association task (distraction) Younger et al. (2010, PLOS One) CONCLUSION: HOW SOCIAL SUPPORT BENEFITS HEALTH • Direct effects hypothesis: social support is generally beneficial during non-stressful as well as stressful times • Buffering hypothesis: physical and mental health benefits of social support are chiefly evident during periods of high stress; when there is little stress, social support may offer few such benefits - social support acts as a reserve and resource that blunts the effects of stress when it is at high levels • Research supports both hypotheses - when researchers have looked at social support in terms of the number of people one identifies as friends and the number of organizations one belongs to, direct effects of social support on health are found - when social support is assessed qualitatively, such as by the number of people perceived to be available who will provide help if it is needed, buffering effects of social support have been found 4) EFFECTIVE KINDS OF SUPPORT • Good marriage • Familial support • Support from the community • Matching support to the stressor – Matching hypothesis: Support that meets the needs of a stressful event is the most effective support WHO PROVIDES SUPPORT? • Social support is ineffective if the type of support provided is not useful • Emotional support is best provided by someone close to the individual • Social support is effective when the person from whom one is seeking support is perceived to be responsive to one’s needs THREATS TO SOCIAL SUPPORT • Stressful events • Intrusive social contact • Controlling or directive support 5) SOCIAL SUPPORT INTERVENTIONS • Giving support has beneficial effects on mental and physical health • Enhancing social support – Forms of beneficial social support systems • Networking/Internet-based systems • Family-based systems • Community-based systems • Interventions against chronic loneliness FAMILY-BASED SYSTEMS • Family support • Enhances patient's physical/emotional functioning • Promotes adherence to treatment • Improves course of illness • Some guidance to families may be necessary in the case of chronic illnesses COMMUNITY-BASED SYSTEMS: SUPPORT GROUPS • Discuss issues of mutual concern that arise as a consequence of stress or illness • Low-cost, convenient treatment option • Can be initiated by a therapist of patient-led • Provide opportunity to share experiences with others confronting similar problems/illnesses CHRONIC LONELINESS INTERVENTIONS • Loneliness affects one in four people and increases the chances of early death by 20% • 30% more people living alone in the US today than there were in 1980 • Contagious • Difficult to treat CHRONIC LONELINESS –INTERVIEW WITH JOHN CACIOPPO • Video notes CHRONIC LONELINESS INTERVENTIONS: FOUR APPROACHES • 1) Social engagement • 2) Social skills training • 3) Social support provision • 4) Changing social-cognitive biases WHICH APPROACH DO YOU THINK WORKED BEST AND WHY? TAKE HOME MESSAGES • 1. • 2. • 3. • 4. • 5. Be Well! ...
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