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

Culture and social support provision: who gives what and why

The present research examined cultural differences in the type and frequency of support provided as well as the motivations underlying these behaviors. Study 1, an open-ended survey, asked participants about their social interactions in the past 24 hours and found that European Americans reported providing emotion-focused support more frequently than problem-focused support, whereas Japanese exhibited the opposite pattern. Study 2, a closed-ended questionnaire study, found that, in response to the close other's big stressor, European Americans provided more emotion-focused support whereas Japanese provided equivalent amounts of emotion-focused and problem-focused support. In addition, Study 2 examined motivational explanations for these differences. Social support provision was motivated by the goal of closeness and increasing recipient self-esteem among European Americans, but only associated with the motive for closeness among Japanese. These studies illustrate the importance of considering cultural context and its role in determining the meaning and function of various support behaviors.

Collectivism and coping: current theories, evidence, and measurements of collective coping

A burgeoning body of cultural coping research has begun to identify the prevalence and the functional importance of collective coping behaviors among culturally diverse populations in North America and internationally. These emerging findings are highly significant as they evidence culture's impacts on the stress-coping process via collectivistic values and orientation. They provide a critical counterpoint to the prevailing Western, individualistic stress and coping paradigm. However, current research and understanding about collective coping appear to be piecemeal and not well integrated. To address this issue, this review attempts to comprehensively survey, summarize, and evaluate existing research related to collective coping and its implications for coping research with culturally diverse populations from multiple domains. Specifically, this paper reviews relevant research and knowledge on collective coping in terms of: (a) operational definitions; (b) theories; (c) empirical evidence based on studies of specific cultural groups and broad cultural values/dimensions; (d) measurements; and (e) implications for future cultural coping research. Overall, collective coping behaviors are conceived as a product of the communal/relational norms and values of a cultural group across studies. They also encompass a wide array of stress responses ranging from value-driven to interpersonally based to culturally conditioned emotional/cognitive to religion- and spirituality-grounded coping strategies. In addition, this review highlights: (a) the relevance and the potential of cultural coping theories to guide future collective coping research; (b) growing evidence for the prominence of collective coping behaviors particularly among Asian nationals, Asian Americans/Canadians and African Americans/Canadians; (c) preference for collective coping behaviors as a function of collectivism and interdependent cultural value and orientation; and (d) six cultural coping scales. This study brings to light the present theoretical and methodological contributions as well as limitations of this body of literature and the implications it holds for future coping research.

The role of peer relationships in parental bereavement during childhood and adolescence

This article reviews current knowledge concerning the relationship between peer support and adjustment outcomes and experiences for parentally bereaved children. A brief overview of the effects of parental bereavement and factors influencing immediate and long-term adjustment is provided, followed by an overview of peer-provided social support and its relationship to adjustment. Current findings on the predictive value of peer support for adjustment are then discussed, with emphasis on the reciprocal positive and negative influences that peer support and adjustment (or lack thereof) exert. Areas of weakness and neglect within this domain are noted, with a focus on methodological issues, peer-relevant consequences of bereavement in need of further research, and the need for study of particular vulnerable subgroups.

Common oxytocin receptor gene (OXTR) polymorphism and social support interact to reduce stress in humans

The neuropeptide oxytocin has played an essential role in the regulation of social behavior and attachment throughout mammalian evolution. Because recent studies in humans have shown that oxytocin administration reduces stress responses and increases prosocial behavior, we investigated whether a common single nucleotide polymorphism (rs53576) in the oxytocin receptor gene (OXTR) might interact with stress-protective effects of social support. Salivary cortisol samples and subjective stress ratings were obtained from 194 healthy male participants before, during, and after a standardized psychosocial laboratory stress procedure. Participants were randomly assigned either to prepare alone or to receive social support from their female partner or close female friend while preparing for the stressful task. Differential stress responses between the genotype groups were observed depending on the presence or absence of social support. Only individuals with one or two copies of the G allele of rs53576 showed lower cortisol responses to stress after social support, compared with individuals with the same genotype receiving no social support. These results indicate that genetic variation of the oxytocin system modulates the effectiveness of positive social interaction as a protective buffer against a stressful experience.

Culturally divergent responses to mortality salience

Two experiments compared the effects of death thoughts, or mortality salience, on European and Asian Americans. Research on terror management theory has demonstrated that in Western cultural groups, individuals typically employ self-protective strategies in the face of death-related thoughts. Given fundamental East-West differences in self-construal (i.e., the independent vs. interdependent self), we predicted that members of Eastern cultural groups would affirm other people, rather than defend and affirm the self, after encountering conditions of mortality salience. We primed European Americans and Asian Americans with either a death or a control prime and examined the effect of this manipulation on attitudes about a person who violates cultural norms (Study 1) and on attributions about the plight of an innocent victim (Study 2). Mortality salience promoted culturally divergent responses, leading European Americans to defend the self and Asian Americans to defend other people.

Let Me Tell You What to Do

Although few decisions are made without seeking advice, advice can challenge the autonomy of its recipient. As a result, it is viewed as potentially intrusive and is enacted cautiously. In part, these findings may reflect European American culture, which fosters respect for personal autonomy. Cultural models of social relationships can affect advice-giving. In contrast to European American cultural context, Russian cultural context fosters an emphasis on practical interdependence. Because advice can promote the exchange of practical information, it is viewed as helpful and is enacted freely. In three studies, we have compared advice-giving across groups from European American and Russian cultural contexts (European Americans, Russians living in Russia, and Russian Americans). Russians living in Russia were more likely than European Americans to give advice, particularly practical advice; less likely to modulate their advice-giving based on whether or not it was solicited; and more likely to describe advice as characteristic of supportive relationships. Together, these studies suggest that advice-giving is a culturally embedded behavior. Cultural models of social relationships can promote unsolicited advice, a seemingly intrusive form of social support, as a way to share information and connect with others.

Characteristics of polytrauma patients with posttraumatic stress disorder in a level 1 trauma center

AIMS

The aims of this study were to determine if the severity of injury is related to the prevalence of posttraumatic stress disorder (PTSD) in polytrauma patients and to review the personality traits of patients with PTSD.

METHODS

During 2006 and 2007, 252 polytrauma patients were treated at the Medical Centre Haaglanden in The Hague, The Netherlands. Of the 174 survivors, 53 adult patients were traced and sent questionnaires. They were screened for PTSD and personality traits, coping styles, and negative cognitions, and their level of social support were assessed.

RESULTS

PTSD was demonstrated in 22.6% of the patients.

CONCLUSIONS

An increased level of neuroticism, negative cognitions regarding themselves, and active dealing were found to be significant predictors of PTSD. However, we found no relation between the injury severity score and the prevalence of PTSD.

Religion, spirituality, social support, and perceived stress in pregnant and postpartum Hispanic women

OBJECTIVE

To examine the association between religion/spirituality and perceived stress in prenatal and postpartum Hispanic women.

DESIGN

Cross-sectional survey.

SETTING

An urban, publicly funded hospital in California.

PARTICIPANTS

Two hundred and forty-eight pregnant and postpartum Hispanic women between age 18 and 45 years.

METHOD

Patients presenting for prenatal or postpartum care or for the first infant visit were recruited to participate in the current study. PARTICIPANTS completed surveys consisting of questions about demographic characteristics, religiosity, spirituality, social support, and stress.

RESULTS

Most participants were unmarried, low-income women with low educational attainment. Ninety percent of women reported a religious affiliation, with more than one half (57.4%) listing their religious affiliation as "Catholic." Overall religiousness/spirituality was significantly associated with increased negative experiences of stress in women who selected English language instruments (Spearman's r=.341, p=.007); there was no such relationship in women who selected Spanish language instruments. Social support and greater relationship quality with a significant other were significantly associated with reduced perceived stress in Spanish reading and English reading women.

CONCLUSIONS

In this sample of pregnant and postpartum Latinas, religiousness/spirituality was not associated with reduced perceived stress and was in fact associated with increased perceived stress among women who selected English-language surveys. Additional research is needed to investigate this association. On the other hand, the current study reinforces the importance of social support and relationship quality for pregnant and postpartum women.

Social support and Quality of Life: a cross-sectional study on survivors eight months after the 2008 Wenchuan earthquake

Background

The 2008 Wenchuan earthquake resulted in extensive loss of life and physical and psychological injuries for survivors. This research examines the relationship between social support and health-related quality of life for the earthquake survivors.

Methods

A multistage cluster sampling strategy was employed to select participants from 11 shelters in nine counties exposed to different degrees of earthquake damage, for a questionnaire survey. The participants were asked to complete the Short Form 36 and the Social Support Rating Scale eight months after the earthquake struck. A total of 1617 participants returned the questionnaires. The quality of life of the survivors (in the four weeks preceding the survey) was compared with that of the general population in the region. Multivariate logistic regression analysis and canonical correlation analysis were performed to determine the association between social support and quality of life.

Results

The earthquake survivors reported poorer quality of life than the general population, with an average of 4.8% to 19.62% reduction in scores of the SF-36 (p < 0.001). The multivariate logistic regression analysis showed that those with stronger social support were more likely to have better quality of life. The canonical correlation analysis found that there was a discrepancy between actual social support received and perceived social support available, and the magnitude of this discrepancy was inversely related to perceived general health (rs = 0.467), and positively related to mental health (rs = 0.395).

Conclusion

Social support is associated with quality of life in the survivors of the earthquake. More attention needs to be paid to increasing social support for those with poorer mental health.

Effects of Life Stress, Social Support, and Cultural Norms on Parenting Styles Among Mainland Chinese, European Canadian, and Chinese Canadian Immigrant Mothers

The effects of life stress, social support, cultural beliefs, and social norms on parenting styles were examined for mainland Chinese (MC), Chinese Canadian (CC) and European Canadian (EC) mothers of 2- to 6-year-old children. Authoritarian parenting increased with stress and traditional parenting beliefs and decreased with social support. EC mothers used less authoritarian parenting than either CC or MC mothers. This cultural difference was fully mediated by stress. For authoritative parenting, there was a country of residence effect, which was not mediated; MCs were less authoritative than either CCs or ECs. All mothers were more authoritative when less stressed, when they had lower traditional childrearing beliefs, and when they were more individualist. The results suggest the importance of the immediate social environment in influencing these cultural differences.

Relational mobility explains between- and within-culture differences in self-disclosure to close friends

In the current research, we tested a novel explanation for previously demonstrated findings that East Asians disclose less personal information to other people than do Westerners. We propose that both between- and within-culture differences in self-disclosure to close friends may be explained by the construct of relational mobility, the general degree to which individuals in a society have opportunities to form new relationships and terminate old ones. In Study 1, we found that cross-cultural differences (Japan vs. United States) in self-disclosure to a close friend were mediated by individuals' perceptions of relational mobility. In Study 2, two separate measures of relational mobility predicted self-disclosure within a single culture (Japan), and this relationship was mediated by the motivation to engage in self-disclosure to strengthen personal relationships. We conclude that societies and social contexts higher in relational mobility (in which relationships can be formed and dissolved relatively easily) produce stronger incentives for self-disclosure as a social-commitment device.

Culture, distress, and oxytocin receptor polymorphism (OXTR) interact to influence emotional support seeking

Research has demonstrated that certain genotypes are expressed in different forms, depending on input from the social environment. To examine sensitivity to cultural norms regarding emotional support seeking as a type of social environment, we explored the behavioral expression of oxytocin receptor polymorphism (OXTR) rs53576, a gene previously related to socio-emotional sensitivity. Seeking emotional support in times of distress is normative in American culture but not in Korean culture. Consequently, we predicted a three-way interaction of culture, distress, and OXTR genotype on emotional support seeking. Korean and American participants (n = 274) completed assessments of psychological distress and emotional support seeking and were genotyped for OXTR. We found the predicted three-way interaction: among distressed American participants, those with the GG/AG genotypes reported seeking more emotional social support, compared with those with the AA genotype, whereas Korean participants did not differ significantly by genotype; under conditions of low distress, OXTR groups did not differ significantly in either cultural group. These findings suggest that OXTR rs53576 is sensitive to input from the social environment, specifically cultural norms regarding emotional social support seeking. These findings also indicate that psychological distress and culture are important moderators that shape behavioral outcomes associated with OXTR genotypes.

Social ties in relation to health status of low-income Brazilian women

BACKGROUND

Social support resources are thought to buffer stressful life events and have been associated with numerous health outcomes in industrialized countries. Because the nature of supportive relationships varies by culture and social class, we studied the relationship of informal social support and networks to self-rated health among low-income women in northeastern Brazil.

METHODS

Participants included 595 randomly sampled mothers from nine low-income communities in Teresina, Piauí, Brazil. Data on sociodemographic variables, social support, quality of the partner relationship, and self-rated health were collected cross-sectionally in 2002. Using multivariable logistic regression, we modeled the association between different aspects of social support and self-rated health.

RESULTS

Poor or fair health was reported by 47% of participants. Women with poor partner relationships had an increased likelihood of poor or fair health (OR 1.7, 95% CI 1.1-2.7), as did those with no material support for food or money (OR 1.6, 95% CI 1.2, 2.0) and no support to resolve a conflict (OR 1.5, 95% CI 1.1, 2.1). Likewise, women with the lowest scores of the Medical Outcomes Study (MOS) social support survey were more likely than other women to report poor or fair health (OR 1.5, 95% CI 1.0, 2.1).

CONCLUSIONS

Poor quality of a partner relationship, lack of support to resolve a conflict, and lack of material support as well as such sociodemographic variables as low education, poor sanitation, and depressive symptomatology are associated with lower health status in a population of low-income women from northeastern Brazil.

Race/ethnicity, social support, and associations with diabetes self-care and clinical outcomes in NHANES

PURPOSE

The purpose of this study was to evaluate how social support and race/ethnicity were associated with diabetes self-care behaviors and clinical outcomes.

METHODS

Using the cross-sectional 2005-2006 National Health and Nutrition Examination Survey (NHANES), the authors examined white, black, and Latino respondents who self-reported a diabetes diagnosis (n = 450), estimating the associations of social support on diabetes outcomes. The primary exposure was a social support index (0-5), which assessed the number of sources of support in one's life. Outcomes were self-care behaviors (controlling weight, exercising, controlling fat/caloric intake, checking feet, and self-monitoring blood glucose) and intermediate clinical outcomes (hemoglobin A1C, diastolic blood pressure, and low-density lipoprotein [LDL]).

RESULTS

There were no differences in social support by race/ethnicity. The authors observed several significant race/ethnicity by social support interactions in adjusted models, controlling for age, gender, education, self-reported health, depression, functional disability, insurance status, and insulin use. Among blacks, social support was associated with controlling weight (odds ratio [OR] = 1.55, P = .03), exercising (OR = 1.38, P = .03), controlling fat/calories (OR = 1.84, P = .03), and lower diastolic blood pressure (beta = -3.07, P = .02). Among whites, social support was associated with lower LDL (beta = -9.45, P = .01). No significant effects were noted for Latinos.

CONCLUSIONS

The relationship of social support with diabetes management differed by race/ethnicity, with the strongest findings among blacks. Social support may be influential for maintaining self-care behaviors among blacks and controlling lipid levels among whites.

Predictors of coping in parents of children with an intellectual disability: comparison between Lebanese mothers and fathers

This cross-sectional study was designed to assess the predictors of coping behaviors of 147 Lebanese parents (101 mothers and 46 fathers) with a child with intellectual disability. It assessed the contribution of child's and parent's characteristics, informal social support, and stress on the coping behaviors of fathers and mothers. Multiple regression analysis confirmed that the father's education, informal social support, and stress were the best predictors of coping. The child's age, severity of illness, and parental health did not significantly contribute to predicting coping behaviors. Contrary to expectations in a Middle Eastern culture, both fathers and mothers reported similar levels of stress, perceived informal social support, and coping. Although informal social support cannot be forced on parents, health professionals can mobilize resources that are culturally sensitive, such as home visitation by nurses or support from other parents. This may especially be beneficial in developing countries with limited resources.

Factor Structure of the Denyes Self Care Practice Instrument (DSCPI-90)

This study evaluates the factor structure and concurrent validity of a measure of self-care, the Denyes Self Care Practice Instrument (DSCPI-90), when used with adults. Three hundred eight participants complete the 18-item DSCPI-90 and a measure of general health status. Data are examined using descriptive statistics, exploratory factor analysis, and correlation. An efficient 12-item, two-factor model is identified. Reducing the number of items from 18 to 12 does not have an untoward effect on either scale reliability or the amount of variance explained. Correlations with a measure of health status are modest, lending validity to the construct of self-care as being distinct from, yet related to, health status. It is concluded that the 12-item version of the DSCPI is reliable and valid when used with adults.

Culture and social support: neural bases and biological impact

Social support is an effective means by which people cope with stressful events, and consequently, it beneficially affects health and well-being. Yet there are profound cultural differences in the effectiveness of different types of support and how people use their support networks. In this paper, we examine research on the impact of culture on social support, the neural underpinnings of social support, and how cultural differences in social support seeking are manifested biologically. We focus on cultural factors that may affect individuals' decisions to seek or not to seek social support and how culture moderates the impact of support seeking on biological and psychological health outcomes. We also examine recent research on the interaction between genes and culture in social support use. Discussion centers on the importance of developing an overarching framework of social support that integrates health psychology, cultural psychology, social neuroscience, and genetics.