Overprotective social support leads to increased cardiovascular and subjective stress reactivity

Profile and mental health characterization of childhood overprotection/overcontrol experiences among Chinese university students: a nationwide survey

Introduction

The childhood experiences of being overprotected and overcontrolled by family members have been suggested to be potentially traumatic. However, the possible associated factors of these experiences among young people are still not well studied. This study aimed to partly fill such gaps by a relatively large, nationwide survey of Chinese university students.

Methods

A total of 5,823 university students across nine different provinces in China were included by the convenience sampling method in the data analyses. All participants completed the overprotection/overcontrol (OP/OC) subscale in a recently developed 33-item childhood trauma questionnaire (CTQ- 33). Data were also collected on all participants' socio-demographic profiles and characterization of mental health. Binary logistic regression was conducted to investigate the associated socio-demographic and psychological factors of OP/ OC.

Results

The prevalence of childhood OP/OC was estimated as 15.63% (910/5,823) based on a cutoff OP/OC subscale score of  ≥ 13. Binary logistic regression suggested that being male, being a single child, having depression, having psychotic-like experiences, lower family functioning, and lower psychological resilience were independently associated with childhood OP/OC experiences (all corrected-p < 0.05). The OP/OC was also positively associated with all the other trauma subtypes (abuses and neglects) in the CTQ-33, while there are both shared and unique associated factors between the OP/OC and other trauma subtypes. Post-hoc analyses suggested that OP/OC experiences were associated with depression in only females and associated with anxiety in only males.

Discussion

Our results may provide initial evidence that childhood OP/OC experiences would have negative effects on young people's mental health which merits further investigations, especially in clinical populations.

Dyad Gender and Relationship Quality Influence Heart Failure Self-Care

Caregivers promote heart failure self-care, yet little is known about how relationship quality and dyad gender influences self-care. The purpose of this study was to evauluate the contribution of dyad gender and relationship quality on heart failure self-care. The study was a secondary analysis from a heart failure self-care intervention. Dyad gender was categorized by patient-caregiver gender as Male-Male (M + M), Female-Female (F + F), Female-Male (Fp + Mc), and Male-Female (Mp + Fc). The Self-Care of Heart Failure Index v.6.2 measured self-care. The Mutuality Scale assessed relationship quality. Univariate linear regression identified determinants of patient self-care maintenance and self-efficacy. The sample (n = 503) was 48% Mp + Fc, 27% F + F, 15% Fp + Mc, and 10% M + M. Better caregiver mutuality in M + M dyads was associated with lower self-care maintenance (b = -7.45, 95% CI [-13.80, -1.11]) and self-efficacy (b = -18.07, 95% CI [-29.11, -7.04]). Better patient mutuality was associated with higher self-efficacy for M + M dyads (b = 12.63, 95% CI [2.18, 23.09]). Mutuality and dyad gender appear important for self-care. Consider the role of gender in the dyad in behavioral interventions.

Effects of parental care and overprotection on adolescents' diurnal cortisol profiles

Parental bonding is a strong determinant of children's health. One of the proposed pathways through which parenting impacts children's health is by altering the functioning of stress response systems. The current study aims to investigate the associations between two types of parental bonding (care and overprotection) and functioning of hypothalamic-pituitary-adrenal (HPA) axis (i.e., diurnal cortisol secretion) in a sample of 255 healthy adolescents (46.3% girls; aged 11-14 years). Participants completed the Parental Bonding Instrument and provided eight cortisol samples across two consecutive days to assess patterns of diurnal cortisol secretion. Multilevel modeling and multiple linear regression were utilized to test the main effects and interactive effects of parental care and overprotection on adolescents' wakeup cortisol, cortisol awakening response, cortisol slope, and total cortisol secretion. Results showed that parental care was associated with higher cortisol levels at awakening, while parental overprotection was associated with lower cortisol levels at awakening. Parental overprotection, but not parental care, was associated with flatter cortisol slopes. No interactive effects between parental care and overprotection on cortisol parameters emerged. The current findings add to the existing literature on parenting behavior and HPA functioning by showing that parental care and overprotection differently regulated daily cortisol parameters implicated in health.

Can Religiosity and Social Support Explain Effects of Trait Emotional Intelligence on Health-Related Quality of Life: A Cross-Cultural Study

Religion and social support along with trait emotional intelligence (EI) help individuals to reduce stress caused by difficult situations. Their implications may vary across cultures in reference to predicting health-related quality of life (HRQoL). A convenience sample of N = 200 chronic heart failure (CHF) patients was recruited at cardiology centers in Germany (n = 100) and Pakistan (n = 100). Results indicated that trait-EI predicted better mental component of HRQoL in Pakistani and German CHF patients. Friends as social support appeared relevant for German patients only. Qualitative data indicate an internal locus of control in German as compared to Pakistani patients. Strengthening the beneficial role of social support in Pakistani patients is one example of how the current findings may inspire culture-specific treatment to empower patients dealing with the detrimental effects of CHF.

The Association Between Cardiac Illness-Related Distress and Partner Support: The Moderating Role of Dyadic Coping

Managing cardiac illness is not easy because it dramatically disrupts people's daily life and both the patient and his/her spouse are at risk for experiencing distress, which, in turn, may affect the support provided by the partner as caregiver. The partner, in fact, is the main source of support, but his/her support may sometimes be inadequate. In addition, dyadic coping (i.e., the way partners cope together against stress and support each other in times of difficulty) could likely be a moderating factor. The main aim of the present study was to examine the role that dyadic coping (DC, in terms of positive, negative, and common dyadic coping responses) plays in moderating the link between patient and partner cardiac illness-related distress (in terms of anxiety and depression) and partner support (in terms of overprotection, hostility, and partner support for patient engagement). The study included 100 married couples faced with cardiac illness who completed a self-report questionnaire. We analyzed our data in PROCESS using multiple regressions in order to assess the moderating effects of DC responses in the relationship between the couple's cardiac illness-related distress and partner support. With regard to patient distress, results showed that higher levels of patient anxiety and depression were linked with ineffective partner support (i.e., overprotection and hostility). With regard to partner distress, higher levels of partner depression were linked with hostility; higher levels of partner depression and anxiety were associated with less partner support for patient engagement. Moreover, the association between distress and partner support was moderated by the quality of DC. In particular, low positive DC represented a risk factor for both the patient and the partner during a cardiac illness, as low positive DC exacerbated the link between patient and partner distress and less effective partner support styles. Also, higher levels of negative DC were risky for couples: The association between distress and less adequate partner supportive behaviors was stronger in the case of higher negative DC. These results imply a need for psychosocial interventions for couples in cardiac illness, especially for couples lacking relational competences, such as positive dyadic coping.

Association of social relationships with incident cardiovascular events and all-cause mortality

Objective

To examine how different aspects of social relationships are associated with incident cardiovascular events and all-cause mortality.

Methods

In 4139 participants from the population-based Heinz Nixdorf Recall study without previous cardiovascular disease (mean (SD) age 59.1 (7.7) years, 46.7% men), the association of self-reported instrumental, emotional and financial support and social integration at baseline with incident fatal and non-fatal cardiovascular events and all-cause mortality during 13.4-year follow-up was assessed in five different multivariable Cox proportional hazards regression models: minimally adjusted model (adjusting for age, sex, social integration or social support, respectively); biological model (minimally adjusted+systolic blood pressure, low-density and high-density lipoprotein cholesterol, glycated haemoglobin, body mass index, antihypertensive medication, lipid-lowering medication and antidiabetic medication); health behaviour model (minimally adjusted+alcohol consumption, smoking and physical activity); socioeconomic model (minimally adjusted+income, education and employment); and depression model (minimally adjusted+depression, antidepressants and anxiolytics).

Results

339 cardiovascular events and 530 deaths occurred during follow-up. Lack of financial support was associated with an increased cardiovascular event risk (minimally adjusted HR=1.30(95% CI 1.01 to 1.67)). Lack of social integration (social isolation) was associated with increased mortality (minimally adjusted HR=1.47 (95% CI 1.09 to 1.97)). Effect estimates did not decrease to a relevant extent in any regression model.

Conclusions

Perceiving a lack of financial support is associated with a higher cardiovascular event incidence, and being socially isolated is associated with increased all-cause mortality. Future studies should investigate how persons with deficient social relationships could benefit from targeted interventions.

Autonomous orientation predicts longevity: New findings from the Nun Study

OBJECTIVE

Work on longevity has found protective social, cognitive, and emotional factors, but to date we have little understanding of the impact of motivational dynamics. Autonomy orientation, or stable patterns of self-regulation, is theorized to be a protective factor for long-term mental and physical health (Ryan & Deci, 2017), and it is therefore a prime candidate for examining how stable psychosocial factors are linked to longevity, or life expectancy.

METHOD

Essays written in the 1930s by participants in the Nun Study were coded for indicators of an autonomy orientation. These were selected in line with an extensive theoretical literature based in self-determination theory (Deci & Ryan, 1985). Essays were coded for the propensity for choice in action, susceptibility to pressure, self-reflection, integration of experiences, and parental support for autonomy. These coded variables were used to predict age of death.

RESULTS

Using 176 codable essays provided by now-deceased participants, linear regression analyses revealed that choiceful behavior, self-reflection, and parent autonomy support predicted age of death. Participants who demonstrated these stable and beneficial motivational characteristics lived longer.

CONCLUSIONS

Personality constructs reflecting a healthy form of self-regulation are associated with long-term health. Implications for health interventions are discussed.

Parental overprotection and youth suicide behavior in low- and middle-income countries: a multilevel analysis of cross-national data

OBJECTIVES

Research on youth suicide behavior has emphasized parent-child relations as a critical protective factor. This study investigates whether "too much" regulation of children, i.e., overprotection, may actually increase the likelihoods of youth suicide intent and plan.

METHODS

Data are drawn from the subset of the Global School-based Student Health Survey (2000-2012), consisting of children living in 48 low- and middle-income countries. Two-level hierarchical linear models are fitted to examine the potential curvilinear (U-shaped) association between parental monitoring and suicide behavior among youth.

RESULTS

Adjusting for individual- and country-level covariates, significant support is found for non-monotonicity specifically among boys: Greater parental involvement in male children's lives lowers both suicide ideation and suicide plan to some extent but, after certain thresholds, increases the odds of both outcomes. Results for girls, however, are much less pronounced.

CONCLUSIONS

In resource-poor countries marked by some of the highest teenage suicide rates in the world, overprotective parenting style is found to have negative and gendered consequences on the mental health of youth. More research is needed to confirm its replicability in economically more developed societies.

Social support as a comfort or an encouragement: A systematic review on the contrasting effects of social support on cardiovascular reactivity

PURPOSE

The stress-buffering hypothesis (Cohen & McKay, 1984, Handbook of psychology and health IV: Social psychological aspects of health (pp. 253-256). Hillsdale, NJ: Lawrence Erlbaum) suggests that one way social support enhances health is by attenuating cardiovascular reactivity (CVR) to stress. Research that has tested this hypothesis has reported inconsistent findings. In this review, we systematically reviewed those findings and proposed a dual-effect model of social support and CVR as a potential explanation for the inconsistency in the literature. Specifically, we proposed that when participants are more engaged during a stressor, social support acts primarily as social comfort, attenuating CVR; and when participants are not engaged, social support acts primarily as social encouragement, elevating CVR.

METHODS

We reviewed 22 previous studies that (1) empirically manipulated social support in a stressful situation, (2) measured CVR, and (3) tested a moderator of social support effects on CVR.

RESULTS

Although a majority of studies reported a CVR-mitigating effect of social support resulting in an overall significant combined p-value, we found that there were different effects of social support on CVR when we considered high- and low-engagement contexts. That is, compared to control conditions, social support lowered CVR in more engaging situations but had no significant effect on CVR in less engaging situations.

CONCLUSION

Our results suggest that a dual-effect model of social support effects on CVR may better capture the nature of social support, CVR, and health associations than the buffering hypothesis and emphasize a need to better understand the health implications of physiological reactivity in various contexts. Statement of contribution What is already known on this subject? According to the stress-buffering hypothesis (Cohen & McKay, ), one pathway social support benefits health is through mitigating the physiological arousal caused by stress. However, previous studies that examined the effects of social support on blood pressure and heart rate changes were not consistently supporting the hypothesis. Some studies reported that social support causes elevations in cardiovascular reactivity (CVR) to stress (Anthony & O'Brien, ; Hilmert, Christenfeld, & Kulik, ; Hilmert, Kulik, & Christenfeld, ) and others showed no effect of social support on CVR (Christian & Stoney, ; Craig & Deichert, ; Gallo, Smith, & Kircher, ). What does this study add? When participants were in more engaging conditions, social support decreased CVR relative to no support. When participants were in less engaging conditions, social support did not have a significant effect on CVR. Provide an alternative way to explain the ways social support affects cardiac health.