Cultural differences in the impact of social support on psychological and biological stress responses

Subjective Socioeconomic Status Matters Less When Perceived Social Support Is High: A Study of Cortisol Responses to Stress

Low objective and subjective socioeconomic status (SES) is associated with the experience of frequent stressors known to have physiological costs. We tested whether perceived social support, a key health-protective resource, buffered the association between lower subjective SES and cortisol responses to an acute stressor. Participants ( N = 115; 54.78% female; age M = 19.56) reported subjective SES and perceived support, completed a social-evaluative stressor task, and provided saliva for cortisol assessment. There was a significant interaction of subjective SES with support predicting linear change in cortisol stress responses, γ = .08, z = 2.34, p = .02. When support was low, subjective SES was strongly related to cortisol, and those who reported lower subjective SES exhibited higher cortisol during recovery than those who reported higher subjective SES. When support was high, those who reported higher and lower subjective SES exhibited similar cortisol responses. These results highlight the important protective role that supportive relationships can have when subjective SES is low.

Social support and networks: cardiovascular responses following recall on immigration stress among Chinese Americans

Social support has been shown to act as a buffer for cardiovascular responses to stress. However, little is known about how social support and networks are related to cardiovascular responses to immigration stress recall. The current study evaluated the impact of structural and functional support on cardiovascular reaction following immigrant stress recall provocation as well as the moderation effect of interdependent self-construal among first-generation Chinese immigrants. One hundred fifty Chinese immigrants were recruited in the New York Chinatown area. Participants completed questionnaires assessing their levels of social support and networks, and interdependent self-construal. Following adaptation, participants recalled a recent post-immigration stress-provoking situation. Cardiovascular measures were taken during adaptation, stressor task, and recovery period. Hierarchical multiple regression analysis was performed. Social network size and type, as well as perceived emotional support were positively predictive of systolic blood pressure (SBP) reactivity changes. Instrumental support seeking was a positive predictor of SBP and diastolic blood pressure (DBP) reactivity. The moderation effect between instrumental support seeking and interdependent self-construal were significantly predictive of DBP reactivity and recovery, suggesting that perceptions about themselves in relation to others is a crucial factor for determining whether support seeking is beneficial or not. Social support was not a direct buffer on cardiovascular responses to stress among Chinese immigrants. Chinese values of interdependence and collectivism may partly explain the disconfirming results. Still, when interdependent self-construal was taken into account, Chinese immigrants who had less interdependent self-construal, but solicited more instrumental support, had faster adaptation to stress over the long term.

Nature, Nurture, and Their Interplay

Cultural neuroscience research examines how psychological processes are affected by the interplay between culture and biological factors, including genetic influences, patterns of neural activation, and physiological processes. In this review, we present foundational and current empirical research in this area, and we also discuss theories that aim to explain how various aspects of the social environment are interpreted as meaningful in different cultures and interact with a cascade of biological processes to ultimately influence thoughts and behaviors. This review highlights theoretical and methodological issues, potential solutions, and future implications for a field that aspires to integrate the complexities of human biology with the richness of culture.

The effects of eliciting implicit versus explicit social support among youths susceptible for late-onset smoking

PURPOSE

Adolescents susceptible to late-onset smoking (becoming regular smokers at age 18 or later) are an understudied population. Social support is a promising target for intervention, but it is important to distinguish between implicit social support (reminders that one belongs to a network of valued others) and explicit social support (seeking and receiving advice and emotional solace). This study aimed to test the potential protective influence of implicit and explicit social support on reducing the risk of late-onset smoking.

METHODS

Fifty-eight smoking-susceptible youths (aged 16-18, 45% African American, 55% non-Hispanic White) completed an experimental session that included a video-recording task designed to elicit thoughts about implicit, explicit, or no social support. Youths reported their behavioral willingness and intentions (BW and BI) to smoke immediately following the social support manipulation; a random sample of 39 youths reported again at a 3-week follow-up.

RESULTS

Following the manipulation, BW and BI for cigarette smoking were significantly higher among youths assigned to the explicit-support condition, compared to those in the implicit-support or control conditions. At follow-up, BW and BI were highest in the explicit-support condition and lowest in the implicit-support condition, but the differences were not significant.

CONCLUSIONS

Overall, findings indicated that for teens susceptible for late-onset smoking, eliciting thoughts about implicit social support produces lower risk for cigarette initiation than does eliciting thoughts about explicit social support. The present results and the video task that yielded them are important to researchers and practitioners interested in reducing the likelihood of late-onset smoking.

Psychological resilience and the gene regulatory impact of posttraumatic stress in Nepali child soldiers

Adverse social conditions in early life have been linked to increased expression of proinflammatory genes and reduced expression of antiviral genes in circulating immune cells-the conserved transcriptional response to adversity (CTRA). However, it remains unclear whether such effects are specific to the Western, educated, industrialized, rich, and democratic (WEIRD) cultural environments in which previous research has been conducted. To assess the roles of early adversity and individual psychological resilience in immune system gene regulation within a non-WEIRD population, we evaluated CTRA gene-expression profiles in 254 former child soldiers and matched noncombatant civilians 5 y after the People's War in Nepal. CTRA gene expression was up-regulated in former child soldiers. These effects were linked to the degree of experienced trauma and associated distress-that is, posttraumatic stress disorder (PTSD) severity-more than to child soldier status per se. Self-perceived psychological resilience was associated with marked buffering of CTRA activation such that PTSD-affected former child soldiers with high levels of personal resilience showed molecular profiles comparable to those of PTSD-free civilians. These results suggest that CTRA responses to early life adversity are not restricted to WEIRD cultural contexts and they underscore the key role of resilience in determining the molecular impact of adverse environments.

The impact of cultural differences in self-representation on the neural substrates of posttraumatic stress disorder

A significant body of literature documents the neural mechanisms involved in the development and maintenance of posttraumatic stress disorder (PTSD). However, there is very little empirical work considering the influence of culture on these underlying mechanisms. Accumulating cultural neuroscience research clearly indicates that cultural differences in self-representation modulate many of the same neural processes proposed to be aberrant in PTSD. The objective of this review paper is to consider how culture may impact on the neural mechanisms underlying PTSD. We first outline five key affective and cognitive functions and their underlying neural correlates that have been identified as being disrupted in PTSD: (1) fear dysregulation; (2) attentional biases to threat; (3) emotion and autobiographical memory; (4) self-referential processing; and (5) attachment and interpersonal processing. Second, we consider prominent cultural theories and review the empirical research that has demonstrated the influence of cultural variations in self-representation on the neural substrates of these same five affective and cognitive functions. Finally, we propose a conceptual model that suggests that these five processes have major relevance to considering how culture may influence the neural processes underpinning PTSD.

Social Network Characteristics, Social Support, and Cigarette Smoking among Asian/Pacific Islander Young Adults

Cigarette smoking may be one of the factors contributing to the high levels of cancer-related mortality experienced by certain Asian/Pacific Islander (A/PI) subgroups (e.g., Native Hawaiian). Given the collectivist cultural orientation attributed to A/PI groups, social strategies are recommended for substance abuse or smoking cessation treatment among A/PI. However, research examining how social network characteristics and social support relate to smoking across A/PI subgroups has been lacking. This study investigated the associations between social network characteristics (e.g., size, composition), perceived social support, and recent cigarette use across Native Hawaiian, Filipino, and East Asian (e.g., Japanese, Chinese) young adults (18-35 year old). Cross-sectional, self-report data were collected from N = 435 participants (M age = 25.6, SD = 8.3; 61% women). Ethnic differences were found in a number of pathways linking social network characteristics, perceived social support, and cigarette smoking. Larger network size was strongly associated with higher perceived social support and lower recent cigarette smoking among Native Hawaiians but not Filipinos or East Asians. Higher perceived social support was associated with lower recent smoking among East Asians and Filipinos but not Native Hawaiians. Implications are discussed with regard to smoking prevention and cessation among A/PI.

The Effectiveness of Somatization in Communicating Distress in Korean and American Cultural Contexts

Previous research has documented that Asians tend to somatize negative experiences to a greater degree than Westerners. It is posited that somatization may be a more functional communication strategy in Korean than American context. We examined the effects of somatization in communications of distress among participants from the US and Korea. We predicted that the communicative benefits of somatic words used in distress narratives would depend on the cultural contexts. In Study 1, we found that Korean participants used more somatic words to communicate distress than US participants. Among Korean participants, but not US participants, use of somatic words predicted perceived effectiveness of the communication and expectations of positive reactions (e.g., empathy) from others. In Study 2, we found that when presented with distress narratives of others, Koreans (but not Americans) showed more sympathy in response to narratives using somatic words than narratives using emotional words. These findings suggest that cultural differences in use of somatization may reflect differential effectiveness of somatization in communicating distress across cultural contexts.

Oxytocin receptor gene polymorphism modulates the effects of social support on heart rate variability

A large body of empirical research has demonstrated stress-buffering effects of social support. However, recent studies suggest that genetic variation of the oxytocin system (specifically, a common single nucleotide polymorphism, rs53576, of the oxytocin receptor gene) modulates the efficacy of social support. The timing and neurobiological basis of this genetic modulation were investigated using a standardized, laboratory-based psychological stress procedure (Trier Social Stress Test for Groups, TSST-G). To index potential stress buffering effects of social support mediated by the oxytocin system, heart rate variability (HRV) was obtained before and during the TSST-G from 40 healthy participants. Results indicate that social support is associated with higher HRV only in G allele carriers. Specifically, social support increased heart rate variability during direct social interaction and only in individuals with at least one copy of the G allele of rs53576. These findings support the idea that the stress-attenuating effects of social support are modulated by genetic variation of the oxytocin system.

Trajectories of relationship stress and inflammatory processes in adolescence

Researchers have identified cross-sectional links between interpersonal stress and inflammation. Little is known, however, about how these dynamics unfold over time, what underlying immune pathways might exist, or whether moderators such as race could alter the strength of the connection between interpersonal stress and inflammatory processes. We examined whether adolescent girls whose relationship trajectories were characterized by chronic stress would exhibit a proinflammatory phenotype marked by systemic inflammation, heightened cytokine responses to bacterial challenges, and resistance to the anti-inflammatory properties of cortisol. Significant Stress × Race interactions revealed that family stress trajectories predicted glucocorticoid sensitivity and peer stress trajectories predicted cytokine production for White but not Asian girls. Relationship stress trajectories were not associated with systemic inflammation, however. These findings suggest that particular subgroups of adolescent girls who face chronic and elevated stress in their close relationships may be at risk for disruptions to the immune system.

Qualities of Inpatient Hospital Rooms: Patients' Perspectives

OBJECTIVES

The aim of this qualitative study was to investigate what design features of hospital rooms are valued by inpatients.

BACKGROUND

Little research has explored how patients evaluate the physical environment of their hospital rooms. Most responses are captured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which includes only two questions about the physical environment.

METHOD

Two hundred thirty-six orthopedic patients (78 in the United States and 158 in Portugal) listed three features of their hospital room that influenced their level of satisfaction with their hospital stay, indicating whether the feature was positive or negative.

RESULTS

The comments were more positive (71.4%) than negative (28.6%). Using the framework of supportive design from Ulrich, over half the comments (64.31%) could be categorized in one of the three dimensions: 33.2% (positive distraction), 22.4% (perceived control), and 6.0% (social support). This total includes Internet (2.7%), which could be categorized as either social support or positive distraction. Comments called "other aspects" focused on overall environmental appraisals, cleanliness, and functionality and maintenance.

CONCLUSIONS

The majority of comments could be accommodated by Ulrich's theory, but it is noteworthy that other aspects emerge from patients' comments and affect their experience. Cross-cultural differences pointed to the greater role of light and sun for Portuguese patients and health status whiteboard for U.S.

PATIENTS

Qualitative research can add significantly to our understanding of the healthcare experience and may inform design decisions.

Intimate-Partner and Client-Initiated Violence among Female Street-Based Sex Workers in China: Does a Support Network Help?

Background

Globally, female street-based sex workers are vulnerable to gender-based violence. Previous research has shown having a peer social network can reduce sex workers’ risks of victimization. However, mechanisms of how social network impacts violence among female street-based sex workers are still far from clear.

Methods

Our study was based on data abstracted from a paper-and-pencil survey administered among 218 female street-based sex workers in Shanghai, China. We focused on self-reported client-initiated violence and intimate-partner violence in emotional, physical, and sexual forms. Social networks were characterized by the size and sources of financial and psychosocial support (e.g. family, friends, and peers). Multi-variable logistic regression was used to estimate adjusted odds ratios (AOR) of each type of violence exposure by social network structure after the adjustment of age, education, and years in Shanghai.

Results

The street-based female sex workers in our study were primarily rural-to-urban migrants (95.7%) with an average age of 41 years old. 24.3% and 62.8% of the sex workers reported intimate-partner violence and client-initiated violence respectively. Lack of financial support, as defined by having only one individual or none in her peer support system to help financially, was significantly associated with self-reported intimate-partner violence (AOR: 2.5; 95% CI: 1.1–5.9). Respondents who reported client-initiated violence, by contrast, were more likely to report lacked psychosocial support from family (AOR: 2.2, 95% CI: 1.0–4.6) and peers (AOR: 5.1, 95% CI: 2.2–11).

Conclusion

This study is one of the first to systematically analyze the associations between social network and gender-based violence among street-based female sex worker. We reported a high prevalence of both types of gender-based violence and their complex associations with family, friends, and peer support network. Policies with goals to reduce violence against women may apply these findings to leverage social network in the interventions against gender-based violence.

Cultural Differences in Support Provision

Emotional expression is highly valued in individualistic cultures, whereas emotional restraint is prioritized in collectivistic cultures. We hypothesized that high-quality relationships in these cultures would exhibit the forms of support provision congruent with their respective expectations. Study 1 examined support transactions among friends in response to a laboratory stressor and found that objectively judged relationship quality (RQ) more strongly positively predicted emotion-focused support provision behaviors by European Americans than by Asian Americans. Study 2, a questionnaire study, found that self-reported RQ predicted emotion-focused support provision more strongly among European Americans than among Japanese. Study 3 investigated more indirect forms of support and found that RQ more strongly predicted worrying about and monitoring close others enduring stressors and spending time with them without talking about the stressor among Asian Americans compared with European Americans. These findings suggest that RQ is expressed in terms of support provision in culturally normative ways.

Parental buffering of fear and stress neurobiology: Reviewing parallels across rodent, monkey, and human models

It has been long recognized that parents exert profound influences on child development. Dating back to at least the seventeenth-century Enlightenment, the ability for parents to shape child behavior in an enduring way has been noted. Twentieth-century scholars developed theories to explain how parenting histories influence psychological development, and since that time, the number of scientific publications on parenting influences in both human and nonhuman animal fields has grown at an exponential rate, reaching numbers in the thousands by 2015. This special issue describes a symposium delivered by Megan Gunnar, Regina Sullivan, Mar Sanchez, and Nim Tottenham in the Fall of 2014 at the Society for Social Neuroscience. The goal of the symposium was to describe the emerging knowledge on neurobiological mechanisms that mediate parent-offspring interactions across three different species: rodent, monkey, and human. The talks were aimed at designing testable models of parenting effects on the development of emotional and stress regulation. Specifically, the symposium aimed at characterizing the special modulatory (buffering) effects of parental cues on fear- and stress-relevant neurobiology and behaviors of the offspring and to discuss examples of impaired buffering when the parent-infant relationship is disrupted.

The Effects of Self-Enhancement and Self-Improvement on Recovery From Stress Differ Across Cultural Groups

Extant research shows that individuals can reflect either adaptively or maladaptively over negative experiences. However, few studies have examined how culture influences this process. We examined the effects of self-enhancement and self-improvement reflection on emotional and physiological recovery from a laboratory social stressor among 56 Asian Americans (interdependent cultural group) and 58 European Americans (independent cultural group). The extent to which people gained emotional and physiological benefits from self-reflection depended on whether the self-reflection processes were congruent with individuals’ heritage cultural backgrounds. When there was a cultural match, participants showed improved emotional recovery, quicker return to baseline levels of cortisol, and greater persistence following the stressor. These findings provide evidence suggesting culturally distinct processes through which individuals recover from negative experiences.

"Please Don't Make Me Ask for Help": Implicit Social Support and Mental Health in Chinese Individuals Living with HIV

China faces a growing HIV epidemic; psychosocial needs of HIV-positive individuals remain largely unaddressed. Research is needed to consider the gap between need for mental healthcare and lack of sufficiently trained professionals, in a culturally acceptable manner. This study assessed explicit and implicit forms of social support and mental health symptoms in 120 HIV-positive Chinese. Explicit social support refers to interactions involving active disclosure and discussion of problems and request for assistance, whereas implicit social support refers to the emotional comfort one obtains from social networks without disclosing problems. We hypothesized and found using multiple linear regression, that after controlling for demographics, only implicit, but not explicit social support positively predicted mental health. Future research is warranted on the effects of utilizing implicit social support to bolster mental health, which has the potential to circumvent the issues of both high stigma and low professional resources in this population.

Subjective well-being, social buffering and hedonic editing in the quotidian

A previous study on the relationship between subjective well-being (SWB) and hedonic editing-the process of mentally integrating or segregating different events during decision-making-showed that happy individuals preferred the social-buffering strategy more than less happy individuals. The present study examined the relationship between SWB, social-buffering and hedonic outcomes in daily life. In Study 1, we used web-based diaries to measure the frequency with which individuals utilised social and non-social buffers as well as daily levels of happiness. Consistent with the previous finding, happy individuals utilised social buffers more frequently than less happy individuals. Interestingly, the utilisation of social buffers had a positive effect on daily happiness among all participants, regardless of individuals' levels of SWB. In Study 2, we found that although the use of social buffers yielded similar effects across groups on online evaluations of events, happy individuals showed a positive bias in global evaluations of past events. This finding suggests that how one construes and remembers the outcomes of social buffering may shape the different hedonic editing preferences among happy and less happy individuals.

Mutual and Non-Mutual Social Support

Social support seeking is not uniformly beneficial for different cultural groups, and in fact, is experienced as less helpful and more distressing for Asians and Asian Americans compared with European Americans. However, relationship factors that may attenuate this cross-cultural difference are little understood. We examined the effects of mutual (i.e., interdependent) and non-mutual support on psychological, biological, and behavioral stress responses to support seeking using a laboratory stressor paradigm. Findings show that across all three distress indicators, East Asian Americans were more benefited when they construed support as mutual versus non-mutual, whereas European Americans’ response did not differ by support condition. Furthermore, the data support previous research showing that Asian Americans are more likely to seek support from discretionary (i.e., peers) than obligatory ties (i.e., parents). Our discussion addresses cultural differences in the priority placed on mutuality, interdependence, and harmony in relationships, and their implications for how people construe their relationships. Future areas for research are discussed.

Social Support in Two Cultures: Everyday Transactions in the U.S. and Empathic Assurance in Japan

We studied received social support using the cross-cultural method of situation sampling. College students from the US and Japan described and rated recent examples of received social support, both everyday support as well as support in response to stress. Middle class, European-American (EuA) students' situations fit a model in which support is frequent and offered freely in interactions, even for relatively minor issues. Even when it's unrequested, EuA support makes recipients feel in control, and support-givers are perceived to have acted by free choice. In contrast, results suggest that middle-class Japanese (Jpn) contexts favor support that is empathic and responsive to the recipients' degree of need. Japanese support was experienced positively when it was emotional support, when it was in more serious situations and when the support was rated as needed by the recipient. In Japan, although problem-based support is most common, it is not particularly positive, apparently because it is less likely to be perceived as needed.

Parentally Bereaved Children and Adolescents

This study investigates peer interaction and peer support for parentally bereaved children and adolescents. Using data from an extensive bereavement study, transcribed semistructured interviews on peer relationships from a sample of 35 parentally bereaved children aged 6 to 15 were systematically coded. Exploratory dimensions of inquiry included incidence counts of teasing, peer interaction regarding bereavement, and preference for interaction, among 12 other dimensions. Hypotheses related to age, gender, and parental death type (anticipated vs. sudden) differences on peer support reception were also tested. Major findings included the following: 71.4% of the sample received support from peers, although 71.4% preferred not to have bereavement-related peer interaction. A significantly greater percentage of females versus males experienced peer support and a positive emotional response, and a significantly greater percentage of children bereaved by anticipated deaths versus sudden deaths had received bereavement-related peer interaction and support. No significant differences were found between younger and older children.

The Trier Social Stress Test as a paradigm to study how people respond to threat in social interactions

In our lives, we face countless situations in which we are observed and evaluated by our social interaction partners. Social-evaluative threat is frequently associated with strong neurophysiological stress reactions, in particular, an increase in cortisol levels. Yet, social variables do not only cause stress, but they can also buffer the neurophysiological stress response. Furthermore, social variables can themselves be affected by the threat or the threat-induced neurophysiological stress response. In order to study this complex interplay of social-evaluative threat, social processes and neurophysiological stress responses, a paradigm is needed that (a) reliably induces high levels of social-evaluative threat and (b) is extremely adaptable to the needs of the researcher. The Trier Social Stress Test (TSST) is a well-established paradigm in biopsychology that induces social-evaluative threat in the laboratory by subjecting participants to a mock job-interview. In this review, we aim at demonstrating the potential of the TSST for studying the complex interplay of social-evaluative threat, social processes and neurophysiological stress responses.

Stressful life events are associated with insulin resistance among Chinese immigrant women in the United States

BACKGROUND

Chinese immigrants experience increased chronic disease risk following migration to the US. Although the impact of lifestyle changes (e.g., diet) on disease risk has been extensively studied, associations of psychosocial stress and disease risk have attracted less attention. Thus, the objective of the present study was to examine associations between stress and insulin resistance in foreign-born Chinese American women.

METHODS

From October, 2005 to April, 2008, 423 women recruited from southeastern Pennsylvania completed questionnaires reporting stressful life events. Blood samples were analyzed for fasting insulin and fasting glucose levels, which were used to estimate insulin resistance according to the homeostasis model assessment (HOMA_IR).

RESULTS

In logistic regression analyses, a greater number of negative life events was associated with insulin resistance (OR=1.17, 95% CI=1.02-1.34), controlling for age, level of acculturation, marital status, body mass index, and waist circumference. Similarly, greater negative life event impact ratings were also associated with insulin resistance (OR=1.08, 95% CI=1.01-1.16) controlling for relevant covariates.

CONCLUSIONS

This is one of the first studies to examine associations between psychosocial stress and insulin resistance in Chinese immigrant women. These findings contribute to a growing body of literature on stress and diabetes risk in an immigrant population.

Canine Comfort: Pet Affinity Buffers the Negative Impact of Ambivalence over Emotional Expression on Perceived Social Support

This study evaluated pet affinity as a buffer between ambivalence over emotional expression (AEE) and social support. AEE occurs when one desires to express emotions but is reluctant to do so and is related to negative psychological outcomes. Individuals high in AEE may have difficulty receiving social support and thus may not gain accompanying benefits. Social support has been associated with positive health outcomes, and pet support is positively associated with human social support. The present study explores the potential protective effect of pet affinity. One hundred ninety-eight undergraduate dog owners completed measures assessing perceived social support, pet affinity, and AEE. AEE was expected to be negatively associated with social support, and pet affinity was expected to buffer the negative effects of AEE on social support. We found that AEE was negatively associated with perceived social support. An interaction between pet affinity and AEE emerged such that the negative association between AEE and social support was weaker among those higher in pet affinity. Thus, at high levels of AEE, those who felt a close connection with their pets reported more perceived social support than those less connected with their pets. Overall, these findings emphasize the potential benefits of pet affinity.

Cross-country differences in basal and stress-induced cortisol secretion in older adults

Objective

Several studies have emphasized the association between socioeconomic status (SES) and inadequate response of the biological stress system. However, other factors related to SES are rarely considered, such as cultural values, social norms, organization, language and communication skills, which raises the need to investigate cross-country differences in stress response. Although some studies have shown differences in cortisol levels between immigrants and natives, there is no cross-country evidence regarding cortisol levels in country-native elders. This is particularly important given the high prevalence of stress-related disorders across nations during aging. The current study examined basal diurnal and reactive cortisol levels in healthy older adults living in two different countries.

Methods

Salivary cortisol of 260 older adults from Canada and Brazil were nalyzed. Diurnal cortisol was measured in saliva samples collected at home throughout two working days at awakening, 30 min after waking, 1400 h, 1600 h and before bedtime. Cortisol reactivity was assessed in response to the Trier Social Stress Test (TSST) in both populations.

Results

Our results showed that even under similar health status, psychological and cognitive characteristics, Brazilian elders exhibited higher basal and stress-induced cortisol secretion compared to the Canadian participants.

Conclusion

These findings suggest that country context may modulate cortisol secretion and could impact the population health.

A content analysis of cognitive and affective uses of patient support groups for rare and uncommon vascular diseases: comparisons of may thurner, thoracic outlet, and superior mesenteric artery syndrome

Rare disease patients are the predominant group of patients who are now connecting online to patient support groups, yet research on their uses of support groups has received little attention. This is a content analysis of three vascular diseases of differing degrees of rarity. Wall posts from Facebook patient support groups for May Thurner syndrome, thoracic outlet syndrome, and superior mesenteric artery syndrome were analyzed over a period of two years. Using Uses and Gratifications as the theoretical framework, the study purpose was to assess how variations in health condition and rarity of condition affect online support group user needs. Results indicated common main cognitive and affective uses across conditions, indicating a consistent pattern of needs communicated by all patients. However, there were nuanced differences in subcategories of cognitive and affective uses between the most and least rare disorders, which inform areas for tailored support mechanisms. Additionally, these vascular patients used their respective support groups primarily for cognitive reasons, especially for the rarest conditions, which informs of basic medical informational needs these patients face related to tests, treatment, surgery, and diagnoses.

Perceptions of support-seeking in young people attending a Youth Offending Team: an interpretative phenomenological analysis

High levels of mental health problems have been identified in young people who have offended (committed/been convicted of a criminal offence). However, as with many young people, they tend not to seek support for their difficulties. This research aimed to explore support-seeking in this population by asking 'What are the perceptions of support-seeking in young people attending a Youth Offending Team?' Semi-structured interviews were carried out with six males (aged 13-18) and the transcripts were analysed using interpretative phenomenological analysis. Four master themes were revealed: Youth Offending Team attendance prompting reflection, Damaged self, Complexity of relationships and Internal conflicts. Generally participants perceived support-seeking as beneficial, but various barriers meant that they did not tend to view it as a viable coping strategy for themselves. Interventions aimed at addressing these barriers may help young people who have offended to seek support.

Effects of occupational stress on the gastrointestinal tract

The aim of this review is to provide a general overview of the relationship between occupational stress and gastrointestinal alterations. The International Labour Organization suggests occupational health includes psychological aspects to achieve mental well-being. However, the definition of health risks for an occupation includes biological, chemical, physical and ergonomic factors but does not address psychological stress or other affective disorders. Nevertheless, multiple investigations have studied occupational stress and its physiological consequences, focusing on specific risk groups and occupations considered stressful. Among the physiological effects of stress, gastrointestinal tract (GIT) alterations are highly prevalent. The relationship between occupational stress and GIT diseases is evident in everyday clinical practice; however, the usual strategy is to attack the effects but not the root of the problem. That is, in clinics, occupational stress is recognized as a source of GIT problems, but employers do not ascribe it enough importance as a risk factor, in general, and for gastrointestinal health, in particular. The identification, stratification, measurement and evaluation of stress and its associated corrective strategies, particularly for occupational stress, are important topics to address in the near future to establish the basis for considering stress as an important risk factor in occupational health.

Biological and psychological markers of stress in humans: focus on the Trier Social Stress Test

Validated biological and psychological markers of acute stress in humans are an important tool in translational research. The Trier Social Stress Test (TSST), involving public interview and mental arithmetic performance, is among the most popular methods of inducing acute stress in experimental settings, and reliably increases hypothalamic-pituitary-adrenal axis activation. However, although much research has focused on HPA axis activity, the TSST also affects the sympathetic-adrenal-medullary system, the immune system, cardiovascular outputs, gastric function and cognition. We critically assess the utility of different biological and psychological markers, with guidance for future research, and discuss factors which can moderate TSST effects. We outline the effects of the TSST in stress-related disorders, and if these responses can be abrogated by pharmacological and psychological treatments. Modified TSST protocols are discussed, and the TSST is compared to alternative methods of inducing acute stress. Our analysis suggests that multiple readouts are necessary to derive maximum information; this strategy will enhance our understanding of the psychobiology of stress and provide the means to assess novel therapeutic agents.

Evaluating PTSD prevalence and resilience factors in a predominantly Asian American and Pacific Islander sample of Iraq and Afghanistan Veterans

BACKGROUND

This study examined the prevalence, and risk and resilience correlates of posttraumatic stress disorder (PTSD) in ethno-racially diverse Operation Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND) Veterans in Hawai'i.

METHODS

A total of 236 OEF/OIF/OND Veterans residing in Hawai'i completed a mail survey.

RESULTS

The majority of Veterans identified themselves as Native Hawaiian/Pacific Islander (34.6%), Asian American (29.3%), or European American (24.5%). Asian American Veterans were significantly less likely to screen positive for PTSD than Native Hawaiian/Pacific Islanders and European Americans (16.4% vs. 44.4% and 39.2%, respectively). Results of hierarchical logistic regression analyses indicated that greater scores on measures of psychological resilience and social support were negatively associated with a positive screen for PTSD in the full sample and in the subsample of European Americans. However, only disclosure norms were associated with PTSD among Native Hawaiian/Pacific Islander Veterans, and none of the variables assessed were associated with PTSD in Asian Americans.

LIMITATIONS

All results are correlational and based on self-report measures; causal inferences cannot be made.

CONCLUSIONS

Culturally distinctive mechanisms likely underlie risk and resilience correlates of PTSD. Understanding these factors will help improve our ability to ameliorate the impact of PTSD, both within and across diverse groups of Veterans.

Social support as a protective factor in suicide: findings from two nationally representative samples

BACKGROUND

Suicide is a problem of worldwide concern and research on possible protective factors is needed. We explored the role of social support as one such factor. Specifically, we hypothesized that increased social support would be associated with decreased likelihood of a lifetime suicide attempt in two nationally representative samples as well as a high-risk subsample.

METHODS

We analyzed the relationship between social support and lifetime history of a suicide attempt, controlling for a variety of related psychopathology and demographic variables, in the National Comorbidity Study Replication (NCS-R), a United States sample and the Adult Psychiatric Morbidity Study (APMS), an English sample.

RESULTS

Results indicate that social support is associated with decreased likelihood of a lifetime suicide attempt controlling for a variety of related predictors in both the full US sample (OR=0.68, p<.001) and the full English sample (OR=0.93, p<.01).

LIMITATIONS

The cross-sectional data do not allow true cause and effect analyses.

CONCLUSIONS

Our findings suggest social support is associated with decreased likelihood of a lifetime suicide attempt. Social support is a highly modifiable factor that can be used to improve existing suicide prevention programs worldwide.

When visibility matters: short-term versus long-term costs and benefits of visible and invisible support

Sixty-one couples engaged in two video-recorded discussions in which one partner (the support recipient) discussed a personal goal with the other partner (the support provider). The support provider's visible and invisible support behaviors were coded by independent raters. Measures of perceived support, discussion success, and support recipients' distress during the discussion were gathered. Recipients also reported their goal achievement at 3-month intervals over the following year. Greater visible emotional support was associated with greater perceived support and discussion success for highly distressed recipients, but it was costly for nondistressed recipients who reported lower discussion success. In contrast, greater invisible emotional support was not associated with perceived support or discussion success, but it predicted greater goal achievement across time. These results advance our current understanding of support processes by indicating that the costs and benefits of visible support hinge on recipients' needs, whereas invisible support shapes recipients' long-term goal achievement.

Psychobiological mechanisms underlying the social buffering of the hypothalamic-pituitary-adrenocortical axis: a review of animal models and human studies across development

Discovering the stress-buffering effects of social relationships has been one of the major findings in psychobiology in the last century. However, an understanding of the underlying neurobiological and psychological mechanisms of this buffering is only beginning to emerge. An important avenue of this research concerns the neurocircuitry that can regulate the activity of the hypothalamic-pituitary-adrenocortical (HPA) axis. The present review is a translational effort aimed at integrating animal models and human studies of the social regulation of the HPA axis from infancy to adulthood, specifically focusing on the process that has been named social buffering. This process has been noted across species and consists of a dampened HPA axis stress response to threat or challenge that occurs with the presence or assistance of a conspecific. We describe aspects of the relevant underlying neurobiology when enough information exists and expose major gaps in our understanding across all domains of the literatures we aimed to integrate. We provide a working conceptual model focused on the role of oxytocinergic systems and prefrontal neural networks as 2 of the putative biological mediators of this process, and propose that the role of early experiences is critical in shaping later social buffering effects. This synthesis points to both general future directions and specific experiments that need to be conducted to build a more comprehensive model of the HPA social buffering effect across the life span that incorporates multiple levels of analysis: neuroendocrine, behavioral, and social.

Cultural differences in professional help seeking: a comparison of Japan and the u.s

Previous research has found cultural differences in the frequency of support seeking. Asians and Asian Americans report seeking support from their close others to deal with their stress less often compared to European Americans. Similarly, other research on professional help seeking has shown that Asians and Asian Americans are less likely than European Americans to seek professional psychological help. Previous studies link this difference to multitude of factors, such as cultural stigma and reliance on informal social networks. The present research examined another explanation for cultural differences in professional help seeking. We predicted that the observed cultural difference in professional help seeking is an extension of culture-specific interpersonal relationship patterns. In the present research, undergraduate students in Japan and the United States completed the Inventory of Attitudes toward Seeking Mental Health Services, which measures professional help seeking propensity, psychological openness to acknowledging psychological problems, and indifference to the stigma of seeking professional help. The results showed that Japanese reported greater reluctance to seek professional help compared to Americans. Moreover, the relationship between culture and professional help seeking attitudes was partially mediated by use of social support seeking among close others. The implications of cultural differences in professional help seeking and the relationship between support seeking and professional help seeking are discussed.

Cultural Neuroscience: Progress and Promise

The nature and origin of human diversity has been a source of intellectual curiosity since the beginning of human history. Contemporary advances in cultural and biological sciences provide unique opportunities for the emerging field of cultural neuroscience. Research in cultural neuroscience examines how cultural and genetic diversity shape the human mind, brain and behavior across multiple time scales: situation, ontogeny and phylogeny. Recent progress in cultural neuroscience provides novel theoretical frameworks for understanding the complex interaction of environmental, cultural and genetic factors in the production of adaptive human behavior. Here, we provide a brief history of cultural neuroscience, theoretical and methodological advances, as well as empirical evidence of the promise of and progress in the field. Implications of this research for population health disparities and public policy are discussed.

Cultural Differences in the Link Between Supportive Relationships and Proinflammatory Cytokines

Research suggests that inflammation may partially mediate the link between supportiveness of social relationships and physical health. However, cultural differences between Asians and European Americans in the nature of relationships and in seeking social support suggest that there may be cultural differences in the relation between supportive relationships and proinflammatory activity. One hundred and twenty-one young adult participants completed assessments of support from their close relationships (parents, romantic partner, and close friends) and provided oral mucosal transudate samples for assessment of the proinflammatory cytokines interleukin-6 (IL-6) and the type II soluble receptor for tumor necrosis factor-α (sTNFαRII). As predicted, more supportive relationships were related to lower levels of IL-6 among European Americans, but not among Asian Americans. There were no relations to sTNFαRII in either group. We conclude that associations between supportive relationships and inflammatory activity may differ in ways that reflect cultural differences in the construal of relationships and social support.

Interpreting a Helping Hand

Research has shown that Asians/Asian Americans are less likely to seek social support to deal with stressful situations than European Americans. Two studies examined the effectiveness of two types of social support: support that is sought directly (solicited support) and support received without prompting from the recipient (unsolicited support). It was theorized that receiving unsolicited support may reinforce social belonging and relational ties, whereas soliciting support may pose relational threats for Asian Americans. In contrast, European Americans may be less affected by type of support received. The first study examined culture (European American vs. Asian American) and type of social support (solicited vs. unsolicited) on stress responses to a task in a lab setting. The second study used vignettes of possible stressors with unsolicited or solicited coping techniques. Results supported our hypothesis, with Asian Americans reporting better outcomes from unsolicited support and European Americans showing little difference between support types.

Perceived social support, coping styles, and Chinese immigrants' cardiovascular responses to stress

BACKGROUND

Social support and coping strategies are important determinants of health, especially for those in the immigrant community adjusting to a new environment.

PURPOSE

This study assessed the buffering effects of perceived social support and different coping styles on cardiovascular reactivity to stress among Chinese immigrants in the New York City Chinatown area.

METHOD

Participants (N = 50, 76% women, and 22-84 years old) completed questionnaires assessing their perceived social support and coping strategy preferences. They were then asked to recall a stress-provoking event related to their immigration experience in a semi-structured interview format.

RESULTS

Hierarchical multiple regression analyses confirmed the interaction effect between perceived social support and problem-focused, emotion-focused, or reappraisal coping on heart rate reactivity. Additionally, Chinese immigrants who upheld more Chinese values were highly correlated with stronger perceived availability of social support and were more likely to incorporate the use of problem-focused and reappraisal coping styles.

CONCLUSION

Findings suggest that high level of social support and the use of reappraisal coping strategies were associated with attenuated cardiovascular responses to stress.

Adolescent Girls’ Experiences of Discrimination

The research examined (a) girls’ responses to personal experiences of gender and/or ethnic/racial discrimination, (b) social support from parents and friends following the discrimination, and (c) the relationship between girls’ reported coping strategies to the discrimination and their self-esteem. Participants were 74 adolescent girls ( M = 16.3 years) from diverse ethnic backgrounds in California. Each girl completed an online survey that included open-ended questions about a personal experience of discrimination and self-reported coping strategies, as well as a questionnaire measure of self-esteem. Results indicate that girls’ reported coping strategies were varied. Avoidance strategies such as ignoring the situation were most common, but many girls also reported use of approach strategies such as confronting the discrimination. Social support from family and friends was related to self-esteem. The study highlights ways in which family and friends may help or hinder girls as they cope with different kinds of discrimination.

Availability, use, and cultivation of support networks as predictors of the well-being of middle-aged and older Chinese: a panel study

OBJECTIVES

To examine the impact of the availability, use, and cultivation of a support network on the well-being of community-dwelling, middle-aged, and older Chinese.

METHODS

A total of 2,970 Hong Kong Chinese aged 40-74 years were interviewed using a structured questionnaire in 2004. Out of the original group of interviewees, 2,120 (71.4%) were interviewed again in 2005.

RESULTS

Structural equation modeling revealed a good fit of the model employing Wave 1 support network data and demographic characteristics to predict Wave 2 well-being. As hypothesized, the availability of important social ties and the cultivation of one's support networks were found to predict well-being one year later, but not the use of support networks to meet emotional, financial, or companion needs after controlling for demographic variables and baseline well-being.

DISCUSSION

Cultivating support networks can be interpreted as positive and active coping. Such cultivation is in line with what socioemotional selectivity theory predicts; specifically, when people age, they become more selective and concentrate on strengthening their relationship with those they are emotionally close to. We argue that network cultivation deserves more attention in theory, practice, and research to strengthen the resilience and adaptability of individuals approaching and experiencing old age.