Culture and Social Support: Who Seeks It and Why?

Intrapersonal and interpersonal dimensions of cancer perception: a confirmatory factor analysis of the cancer experience and efficacy scale (CEES)

PURPOSE

Sociocultural factors influence psychological adjustment to cancer in Asian patients in two major ways: prioritization of relationships over individual orientations and belief in the efficacy of interpersonal cooperation. We derived and validated among Chinese colorectal cancer (CRC) patients an instrument assessing cancer perceptions to enable the study of the sociocultural processes.

PATIENTS AND METHODS

Qualitative interviews (n = 16) derived 15 items addressing interpersonal experience in Chinese CRC patients' adjustment. These 15 items and 18 corresponding self-referent items were administered to 166 Chinese CRC survivors and subjected to exploratory factor analysis (EFA) to establish the initial scale structure and reliability. The final 29 items, together with other psychometric measures, were administered to a second cohort of 215 CRC patients and subjected to confirmatory factor analysis (CFA).

RESULTS

EFA (63.35% of the total variance) extracted six factors: personal strain, socioeconomic strain, emotional strain, personal efficacy, collective efficacy, and proxy efficacy. CFA confirmed the psychometric structure [chi (2)(df) = 702.91(368); Comparative Fit Index = 0.95; Nonnormed Fit Index = 0.94; Incremental Fit Index = 0.95; standardized root mean square residual = 0.08] of the six factors by using a model with two latent factors: experience and efficacy. All subscales were reliable (alpha = 0.76-0.92). Appropriate correlations with adjustment outcomes (symptom distress, psychological morbidity, and subjective well-being), optimistic personalities, and social relational quality indicated its convergent and divergent validity. Known group comparisons (i.e., age, active treatment, and colostomy) showed its clinical utility.

CONCLUSION

The cancer experience and efficacy scale is a valid multidimensional instrument for assessing intrapersonal and interpersonal dimensions of cancer experience in Asian patients, potentiating existing patient-reported outcome measures.

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.

More on the Social Sharing of Emotion: In Defense of the Individual, of Culture, of Private Disclosure, and in Rebuttal of an Old Couple of Ghosts Known as “Cognition and Emotion”

Though the commentaries on my review welcomed its focus on the social dimension of emotion and emotion regulation, they also revealed important misinterpretation. The social standpoint was not developed at the expense of the individual. On the contrary, this perspective is in line with dynamic emotions systems views. Despite variations in modalities, I argue that emotion sharing is universal because it concerns culturally-shaped knowledge and constructions when they are shattered by emotional events. Predictions regarding the recovery effects of private disclosure are formulated, particularly in reference to the notions of speech styles and psychological differentiation. Finally, differentiating cognition and emotion is becoming more and more foggy and I agree that the time has come for new, less fuzzy, concepts.

Gender differences in relationships between social capital and individual smoking and drinking behavior in Taiwan

Despite the concept of social capital receiving great attention in the area of health research, few studies have analyzed the differential effects of social capital between genders. This article assesses gender differences in the relationships between social capital and smoking and drinking behavior in Taiwan. Data on individual sociodemographic characteristics, smoking, drinking, and social capital were obtained from the Taiwan Social Change Survey conducted in 1995 and in 2000. The overall response rate was 67%. In total, 3713 women and men aged over 20 years living in 204 neighborhoods were interviewed. Social capital indicators were aggregated at the neighborhood level, and included neighborhood closeness, political influence, social contact, social trust, and social participation. The data were analyzed with multilevel binomial regression models. Gender differences were found in some aspects of social capital. Stronger effects of social trust on smoking were found for women than for men, whereas stronger effects of neighborhood closeness on drinking were found for women than for men. Social participation was positively associated with drinking in both genders. The findings of this study provide new evidence for the differential effects of social capital by gender in Taiwan, suggesting that more studies are needed to understand social capital's effects in Asian societies and the mechanisms by which the effects may vary with gender.

United States and Finnish Adolescents' Perceptions of Social Support

The purpose of the current preliminary study was to examine the levels of perceived social support by adolescents in the US and Finland. American research has demonstrated that high perceived levels of social support can buffer adolescents against many negative psychosocial symptoms, such as depression, anxiety and low self-esteem and is a necessary resource in adolescent well-being (Demaray and Malecki, 2002). Research on social support in Finland has demonstrated similar effects. However, less is known about the potential differences in the perceptions of social support cross-culturally. Perceptions of the frequency of different sources and types of support were assessed in both countries ( n = 148 US, n = 144 Finland) via the Child and Adolescent Social Support Scale (CASSS; Malecki et al., 2000). US participants perceived higher levels of both source and type of social support. These preliminary analyses serve as a springboard for further cross-cultural social support research.

Toward a Further Understanding of the Relationships Between Perceptions of Support and Work Attitudes

This study (a) compared the effect of perceived supervisor support (PSS) and perceived coworker support (PCS) on work attitudes; (b) examined the moderating role of gender, tenure, and job type in the support—attitude relationship; and (c) tested a theoretical model hypothesizing relationships among PCS, PSS, perceived organizational support, and work attitudes. In a meta-analysis, PSS was found to be more strongly related to job satisfaction (.52 vs. .37), affective commitment (.48 vs. .28), and turnover intention (—.36 vs. —.19) than was PCS. Further, job type (customer-contact vs. non-customer-contact jobs) was found to be a significant moderator. Finally, the proposed model received empirical support. Different forms of support were closely related to work attitudes and to each other. Implications for research on social support are discussed.

Is perceived emotional support beneficial? Well-being and health in independent and interdependent cultures

Previous studies show there is little or no association between perceived emotional support and well-being in European American culture. The authors hypothesized that this paradoxical absence of any benefit of perceived support is unique to cultural contexts that privilege independence rather than interdependence of the self. Study 1 tested college students and found, as predicted, that among Euro-Americans a positive effect of perceived emotional support on subjective well-being (positive affect) was weak and, moreover, it disappeared entirely once self-esteem was statistically controlled. In contrast, among Asians in Asia (Japanese and Filipinos) perceived emotional support positively predicted subjective well-being even after self-esteem was controlled. Study 2 extended Study 1 by testing both Japanese and American adults in midlife with respect to multiple indicators of well-being and physical health. Overall, the evidence underscores the central significance of culture as a moderator of the effectiveness of perceived emotional support.

Culture, interpersonal perceptions, and happiness in social interactions

The authors examined cultural differences in interpersonal processes associated with happiness felt in social interactions. In a false feedback experiment (Study 1a), they found that European Americans felt happier when their interaction partner perceived their personal self accurately, whereas Asian Americans felt happier when their interaction partner perceived their collective self accurately. In Study 1b, the authors further demonstrated that the results from Study 1a were not because of cultural differences in desirability of the traits used in Study 1a. In Studies 2 and 3, they used a 2-week event sampling method and replicated Study 1. Unlike Asian Americans, African Americans were not significantly different from European Americans in the predictors of happiness in social interactions. Together, this research shows that interpersonal affirmation of important aspects of the self leads to happiness and that cultural differences are likely to emerge from the emphasis placed on different aspects of the self.

Downsides of an overly context-sensitive self: implications from the culture and subjective well-being research

The self becomes context sensitive in service of the need to belong. When it comes to achieving personal happiness, an identity system that derives its worth and meaning excessively from its social context puts itself in a significantly disadvantageous position. This article integrates empirical findings and ideas from the self, subjective well-being, and cross-cultural literature and tries to offer insights to why East Asian cultural members report surprisingly low levels of happiness. The various cognitive, motivational, behavioral, and affective characteristics of the overly relation-oriented self are discussed as potential explanations. Implications for the study of self and culture are offered.

Depression and Korean American immigrants

Koreans are a relatively new and fast-growing immigrant group in the United States. Research has shown that immigration experiences are associated with depression, whereas acculturation and social support are moderating factors. Korean culture is informed by Confucianism, which emphasizes family integrity, group conformity, and traditional gender roles, and has influenced how Korean immigrants conceptualize depression, express depressive symptoms, and demonstrate help-seeking behavior. An understanding of Korean patterns of manifesting and expressing depression will be helpful to provide culturally appropriate mental health services to Korean American immigrants.

What Do We See in a Tilted Square? A Validation of the Figure Independence Scale

The Figure Independence Scale (FIS) assesses people's preference for abstract figures that represent uniqueness. As psychological manifestations of cultural values cohere among each other within a cultural system, the authors argue that preference for uniqueness, as a psychological manifestation of the value for independence, can be used as an indirect measure of this value. Four studies examine the convergent, discriminant, and predictive validity of the FIS. The results indicate that liking for abstract, unique figures coheres with other specific manifestations of the value for independence (i.e., responses to explicit independence scale, need for personal control, liking for independence themes in advertisements, and use of social coping) and thus can be used as a measure of individuals' more global endorsement of this individualistic value.

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

Social support is believed to be a universally valuable resource for combating stress, yet Asians and Asian Americans report that social support is not helpful to them, resist seeking it, and are underrepresented among recipients of supportive services. We distinguish between explicit social support (seeking and using advice and emotional solace) and implicit social support (focusing on valued social groups) and show that Asians and Asian Americans are psychologically and biologically benefited more by implicit social support than by explicit social support; the reverse is true for European Americans. Our discussion focuses on cultural differences in the construal of relationships and their implications for social support and delivery of support services.

An empirical evaluation of social support and psychological well-being in older Chinese and Korean immigrants

OBJECTIVES

To examine, among older Chinese and Korean immigrants: (1) the concept and measurement of perceived social support; (2) levels of social support and psychological well-being by living arrangement; and (3) whether social support is positively related to psychological well-being.

DESIGN

A convenience sample of 200 self-identified Chinese and Koreans, aged 65 years and older, were interviewed. Psychometric analysis was conducted to examine the reliability and validity of a new social support measure. Bivariate and multivariate analyses were used to examine the relationship between social support and psychological well-being.

RESULTS

Factor analysis revealed a four-factor solution of social support and adequate psychometrics of all social support scales was found. Multivariate results suggest that Koreans have more depression than Chinese (p < 0.01). Those who lived with their spouse and adult children had lower overall psychological well-being (p < 0.05) and lower positive affect (p < 0.05) compared to those who lived alone. Having more emotional/companionship support significantly (p < 0.001) contributed to better overall psychological well-being, having less depression and higher positive affect.

CONCLUSIONS

A new multidimensional social support measure for use with older Chinese and Koreans could be useful upon further validation. These results suggest that older Chinese and Koreans' psychological well-being may be negatively affected when they live with their adult children. More depression in Koreans may be related to difficulties in expanding their social network beyond Korean-speaking people.

Social Support and Health: A Review of Physiological Processes Potentially Underlying Links to Disease Outcomes

Social support has been reliably related to lower rates of morbidity and mortality. An important issue concerns the physiological mechanisms by which support influences such health endpoints. In this review, I examine evidence linking social support to changes in cardiovascular, neuroendocrine, and immune function. Consistent with epidemiological evidence, social support appears to be related to more positive "biological profiles" across these disease-relevant systems. Recent research on immune-mediated inflammatory processes is also starting to provide data on more integrative physiological mechanisms potentially linking social support to health. The implications of these links, along with future research directions are discussed.

Factor structure of the Korean version of illness intrusiveness rating scale: cross-cultural implications

The Illness Intrusiveness Rating Scale (IIRS) measures illness-induced disruptions to 13 domains of lifestyles, activities, and interests. A stable three-factor structure has been well documented; however, the cross-cultural validity of this scale needs to be tested. This study investigated the factor structure of the Korean version of IIRS in 712 outpatients at a university medical center. A predominant diagnosis of the patients was rheumatoid arthritis (47%). The Center for Epidemiological Studies-Depression Scale (CES-D), and Health Assessment Questionnaire (HAQ) were also administered. Exploratory Principal Component Analysis identified a two-factor structure, "Relationships and Personal Development (RPD)" and "Instrumental", accounting for 57% of the variance. Confirmatory analyses extracted an identical factor structure. However, a goodness-of-the fit test failed to support two-factor solution (chi(2)=138.2, df=43, p<.001). Two factors had high internal consistency (RPD, alpha=.89; Instrumental, alpha=.75) and significantly correlated with scores of HAQ (RPD, r=.53, p<.001; Instrumental, .r=44, p<.001) and CES-D (RPD, .r=55, p<.001; Instrumental, .r=43, p<.001). These findings supported construct validity of the Korean version of IIRS, but did not support cross-cultural equivalence of the factor structure.