Social Network Structure and Combating Social Disconnection: Implications for Physical Health

Application of an egocentric social network approach to examine changes in social connections following treatment for anxiety and depression: A novel measurement tool for clinical trials research?

The epidemic of loneliness and social isolation has been recognized as a public health crisis warranting the same prioritization as other public health issues today, such as obesity, substance use disorders, and tobacco use. Social disconnection is particularly prevalent and disabling among individuals with anxiety and depression, yet it is inadequately evaluated and addressed in most clinical psychology treatment research. Studies generally employ global measures of perceived connectedness, loneliness, or relationship satisfaction, limiting understanding about elements of one's social network that may change with treatment. This study examined changes in the degree (number of people nominated) and quality of one's social network from pre-to post-treatment using an egocentric social network approach in 59 adults (mean age = 30.8 years, range = 18 to 54) with clinically elevated anxiety or depression who were randomized to a cognitive and behavioral positive valence treatment versus waitlist. Participants (egos) named people in their lives (alters) with whom they discussed important issues or spent free time. For each alter, participants rated how close they felt, how close they thought the alter felt to them, and how frequently they communicated. Linear regressions, which included treatment group as a predictor, revealed no group differences in changes in network degree, perceived alter feelings of closeness, or communication frequency, despite prior findings from this sample indicating larger increases in perceived global connectedness in the treatment group. Unexpectedly, the control group reported a greater increase in perceived closeness to alters. Post-hoc analyses revealed this was explained by the treatment group identifying more distal social ties (e.g., extended family, colleagues, roommates) as alters following treatment - an outcome positively associated with global improvements in connectedness. This proof-of-concept study suggests egocentric social network surveys may provide unique information on treatment-related changes in social functioning. Suggestions are provided for adaptations to facilitate application of social network surveys to mental health treatment research.

The effects of COVID-19-era unemployment and business closures upon the physical and mental health of older Europeans: Mediation through financial circumstances and social activity

COVID-19-era lockdown policies resulted in many older persons entering unemployment, facing financial difficulties and social restrictions, and experiencing declining health. Employing the Survey of Health, Ageing and Retirement in Europe's first COVID-19 module (summer 2020) (N = 11,231) and the Karlson-Holm-Breen method for decomposition of effects within non-linear probability models (logistic regression modelling), we examined associations of pandemic-era lost work with older Europeans' (50-80 years of age) self-assessed health, depressive symptoms, and anxiety symptoms, and mediation through households' difficulties making ends meet, loneliness, and curtailed face-to-face contact with non-relatives. We find that lost work was associated with detriments in all three health outcomes. Total mediation was 23% for worsened self-assessed health, 42% for depressive symptoms, and 23% for anxiety symptoms. In all cases, combined mediation through the two social activity variables was approximately twice the magnitude of mediation through household financial difficulties. This evidence highlights the extent of employment's value for friendship formation and sustenance, and social activity, during the pandemic-era social restrictions. This might be accentuated among older persons because of the social constrictions often concomitant to advancing age. These results emphasize that the social correlates of lost employment, beyond the financial concomitants, should receive thorough research and policy attention, perhaps especially for older adults during public health crises.

Effect of online and offline social network group clusters on life satisfaction across age groups

Background

Positive social relationships are critical for better subjective well-being across ages. Future research will benefit from examining how to improve life satisfaction by utilizing social groups in new, ever-changing social and technological contexts. This study aimed to evaluate the effect of online and offline social network group clusters on life satisfaction across different age groups.

Methods

Data were derived from the Chinese Social Survey (CSS) (2019), which is a nationally representative survey. We adopted a K-mode cluster analysis algorithm to categorize participants into four clusters according to their online and offline social network groups. ANOVA and chi-square analysis were used to understand the associations among age groups, social network group clusters, and life satisfaction. Multiple linear regression was applied to identify the association between social network group clusters and life satisfaction across age groups.

Results

Younger and older adults had higher life satisfaction than middle-aged adults. Individuals who joined diverse social network groups had the highest life satisfaction, followed by those who joined personal and working social groups, while those who joined restricted social groups had the lowest life satisfaction (F = 81.19, p < 0.001). According to the results of multiple linear regression, individuals who belonged to diverse social groups had higher life satisfaction than those who belonged to restricted social groups among adults aged 18-59 years, except students (p < 0.05). Individuals who joined personal and working social groups had higher life satisfaction than those who joined restricted social groups among adults aged 18-29 and 45-59 years (β = 2.15, p < 0.01; β = 1.45, p < 0.01).

Conclusions

Interventions to promote participation in diverse social network groups among adults aged 18-59 years, except for students, are highly recommended to improve life satisfaction. Health practitioners could provide interventions to encourage young and middle-aged adults to join both personal and working social groups.

Examining Between-Group Differences in Social Network Density and High-Sensitivity C-Reactive Protein in Older Adults: Implications for the Hispanic Mortality Paradox

OBJECTIVE

Hispanic/Latino(x) and African American/Black older adults experience disproportionate cardiometabolic disease burdens when compared with their non-Hispanic White counterparts. Sources of resilience such as social networks have been found to mitigate the risk of this disease and its end points like high-sensitivity C-reactive protein (hs-CRP). However, little is known about the social network infrastructure among these groups. Moreover, existing work has largely ignored the degree to which members of one's network are connected to one another (network density), which may be important for navigating structural barriers within interdependent groups. The objective of this study was to understand the association between network density and 5-year hs-CRP (blood spot) and whether this association was moderated by race-ethnicity.

METHODS

A subsample of Hispanic/Latino(x), African American/Black, and non-Hispanic White older adults ( N = 1431) from the National Social Life Health and Aging Project was used. Multivariable regression was used to estimate the association between network density and its interaction with race-ethnicity, with hs-CRP 5 years later.

RESULTS

Although no main effect of network density on 5-year hs-CRP was found, results revealed a significant network density by race-ethnicity interaction (Wald χ2 (2, 1242) = 3.31, p = .037). Simple slopes analyses revealed that Hispanic/Latino(x) older adults with high network density had significantly lower hs-CRP levels when compared with their same-ethnic counterparts with low network density ( b = -0.73, standard error = 0.31, 95% confidence interval = -1.33 to -0.13, p = .018).

CONCLUSIONS

Results demonstrate population-level differences in social network structure and differential associations of this infrastructure with health. Implications for the Hispanic Mortality Paradox are discussed.

Flourishing despite Chronic Obstructive Pulmonary Disease (COPD): Findings from a Nationally Representative Survey of Canadians Aged 50 and Older

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality and is often associated with serious disability and depression. Little is known about the characteristics of those who are in complete mental health (CMH) despite having COPD. This study’s objectives are to: (1) estimate the prevalence and odds of absence of psychiatric disorders (APD) and CMH among older adults that reported having COPD, compared to their peers that did not; (2) identify factors associated with APD and with CMH. Bivariate and logistic regression analyses were conducted using the nationally representative Canadian Community Health Survey—Mental Health. The results indicate that there was a significantly (p < 0.001) lower prevalence of APD (86.7% vs. 95.0%) and CMH (66.7% vs. 77.0%) among older adults aged 50+ with COPD (n = 703) compared to those without COPD (n = 10,189). Half of the sample was female (50.5%) and the majority of whom were under age 70 (62.5%). Factors significantly (p < 0.05) associated with higher odds of APD and of CMH among older adults with COPD include being married, having a confidant, being physically active, and having no lifetime history of major depressive disorder or generalized anxiety disorder. For every additional adverse childhood experience, the odds of APD declined by 31%. The majority of those with COPD are mentally flourishing despite having this disabling and life-threatening disorder. These findings underline the importance of targeted interventions and outreach to those most vulnerable to poorer mental health outcomes including the socially isolated.

Exploring Social Support Networks and Interactions of Young Adult and LGBTQIA+ Cancer Survivors and Care Partners

Purpose

The purpose of this study was to describe the social support networks and daily support interactions of cancer-affected individuals, including young adult (YA) and LGBTQIA+ survivors and care partners.

Methods

Participants were recruited at two United States cancer centers and via social media for a pilot study testing a novel online method for collecting prospective, daily social support interaction data (N=28). All participants were aged 18+; survivors had a current or recent cancer diagnosis and were engaged in treatment and/or services; care partners were identified by the survivors. Enrollment also purposefully targeted YA and LGBTQIA+ survivors. Social network data (up to 10 members) were assessed at baseline. Daily online surveys assessed support interactions between participants and specific network members over 14 days. Descriptive statistics summarized data and explored between-group (YA/non-YA, LGBTQIA+/non-LGBTQIA+) differences in social network characteristics (size, heterogeneity, density, centralization, cohesion) and support interactions (support source and type).

Results

There were no significant differences between YA and non-YA participants on any measures. LGBTQIA+ participants’ support networks were less dense (Mdn=0.69 vs. 0.82, p=.02), less cohesive (Mdn=0.85 vs. 0.91,.02), more centered on the participant (Mdn=0.40 vs. 0.24, p=.047), and included more LGBTQIA+ members (Mdn=0.35 vs. 0.00, p<.001). LGBTQIA+ participants reported having more interactions with LGBTQIA+ network members (Mdn=14.0 vs. Mdn=0.00, p<.001) and received significantly more of all types of support from LGBTQIA+ vs. non-LGBTQIA+ members. LGBTQIA+ participants also reported receiving more appraisal support than non-LGBTQIA+ (Mdn 21.64 vs. 9.12, p=.008) including more appraisal support from relatives (Mdn=11.73 vs 6.0, p+.037).

Conclusions

Important information related to support access, engagement, and needs is embedded within the everyday contexts of the social networks of cancer-affected people. Individualized, accessible, and prospective assessment could help illuminate how their “real world” support systems are working and identify specific strengths and unmet needs. These insights would inform the development of more culturally competent and tailored interventions to help people understand and leverage their unique support systems. This is particularly critical for groups like YA and LGBTQIA+ survivors and care partners that are underserved by formal support services and underrepresented in cancer, caregiving, and social support research.