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Gray KE, Silvestrini M, Ma EW, Nelson KM, Bastian LA, Voils CI. Gender differences in social support for diabetes self-management: A qualitative study among veterans. PATIENT EDUCATION AND COUNSELING 2023; 107:107578. [PMID: 36463824 DOI: 10.1016/j.pec.2022.107578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/04/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Describe the role of social support in veterans' diabetes self-management and examine gender differences. METHODS We conducted semi-structured interviews among veterans with diabetes from one Veterans Health Administration Health Care System. Participants described how support persons influenced their diabetes self-management and perspectives on a proposed self-management program incorporating a support person. We used thematic analysis to identify salient themes and examine gender differences. RESULTS Among 18 women and 18 men, we identified four themes: 1) women felt responsible for their health and the care of others; 2) men shared responsibility for managing their diabetes, with support persons often attempting to correct behaviors (social control); 3) whereas both men and women described receiving instrumental and informational social support, primarily women described emotional support; and 4) some women's self-management efforts were hindered by support persons. Regarding programs incorporating a support person, some participants endorsed including family/friends and some preferred programs including other individuals with diabetes. CONCLUSIONS Notable gender differences in social support for self-management were observed, with women assuming responsibility for their diabetes and their family's needs and experiencing interpersonal barriers. PRACTICE IMPLICATIONS Gender differences in the role of support persons in diabetes self-management should inform support-based self-management programs.
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Affiliation(s)
- Kristen E Gray
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
| | - Molly Silvestrini
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Erica W Ma
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Karin M Nelson
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; General Medicine Service, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Division of General Internal Medicine, University of Washington, Seattle, WA, USA
| | - Lori A Bastian
- Pain Research, Informatics, Multimorbidities, Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA; Yale University School of Medicine, New Haven, CT, USA
| | - Corrine I Voils
- William S. Middleton Memorial Veterans Administration Hospital, Madison, WI, USA; Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
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2
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Li N, Zhao S, Liu C, Dai K, Huang W. Exploring the relationship between perceived social support and college students' autonomous fitness behavior: Chain mediating effect test. Front Psychol 2023; 13:1036383. [PMID: 36817388 PMCID: PMC9928751 DOI: 10.3389/fpsyg.2022.1036383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/19/2022] [Indexed: 02/04/2023] Open
Abstract
Objective This study aims to explore the effect of perceived social support on college students' autonomous fitness behavior, and the mediating role of mental toughness and exercise self-efficacy. Methodology A survey participated by 985 college Students (average age, 19.55) was conducted by applying the following scales: The Perceived Social Support Scale, the Adolescent Self-Government Behavior Scale, the Mental Toughness Scale, and the Exercise Self-efficacy Scale (ESES). Results (1) Perceived social support can directly and positively predict autonomous fitness behavior, mental toughness, and exercise self-efficacy; mental toughness can directly and positively predict exercise self-efficacy. Likewise, perceived social support, mental toughness, and exercise self-efficacy can positively predict autonomous fitness behavior. (2) The indirect effect of the path with mental toughness as the mediating variable is 0.078, the indirect effect of the path with exercise self-efficacy as the mediating variable is 0.122, and the indirect effect of the path with mental toughness and exercise self-efficacy as the mediating variable is 0.082. (3) The total of all indirect effects is 0.282, and the effects of the three indirect pathways account for 18.25, 28.62, and 19.37% of the total, respectively. Conclusion The perceived social support can indirectly predict college students' autonomous fitness behavior through the independent mediating effect of mental toughness and self-efficacy, as well as the chain mediating effect of the two. The claim that mental toughness and exercise self-efficacy perform a chain-mediate role in the positive effect brought by perceived social support on autonomous fitness behavior has been supported. This study revealed the relationship and mechanism between perceived social support and college students' autonomous fitness behavior and further improved the research on the impact of perceived social support on college students' autonomous fitness behavior.
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Affiliation(s)
| | | | - Chanjuan Liu
- School of Physical Education, Shandong University of Science and Technology, Qingdao, China
| | - Kun Dai
- School of Physical Education, Shandong University of Science and Technology, Qingdao, China
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Groves J, Luberto C, Fricchione G, Park E. Further Examination of the Psychometric Properties of the Current Experiences Scale and Model of Resiliency. Glob Adv Health Med 2022; 11:2164957X221128521. [PMID: 36213314 PMCID: PMC9536098 DOI: 10.1177/2164957x221128521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/27/2022] [Accepted: 09/07/2022] [Indexed: 11/07/2022] Open
Abstract
Background Stress-related disease is increasing, with high resilience proposed as protective. Whilst the Current Experiences Scale (CES) shows promise as a measure of resilience, its psychological correlates and relationship to psychological stress remain unclear. Objectives (1) Further explore the psychometric properties of the CES, (2) identify modifiable psychological factors associated with the CES and (3) test a previously published model for the influence of adaptive strategies and stress management factors on resiliency and stress. Methods N = 455 individuals (mean age = 47.8, 65.1% female) completed measures of adaptive strategies: mindfulness (Cognitive and Affective Mindfulness Scale-Revised), positive affect (Positive and Negative Affect Schedule) and gratitude (The Gratitude Questionnaire), stress management skills: coping (Measure of Current Status-A), depression (Patient Health Questionnaire-8) and anxiety (General Anxiety Disorder Assessment) and outcomes: resilience (CES) and stress (Perceived Stress Scale). Cronbach's alpha and confirmatory factor analysis (CFA) examined the psychometric properties of the CES. Multivariable regression identified psychological variables associated with resilience. Structural equation modelling (SEM) tested the previously published model for resilience. Results The CES and its subscales showed good internal consistency (ɑ = .75-.93). The 23-item CES produced excellent results for model fit (Root Mean Square Error of Approximation (RMSEA) = .07, Standardized Root Mean Square Residual (SRMR) = .06, Comparative Fit Index (CFI) = .99; Tucker-Lewis Index (TLI) = .99). Higher gratitude (P < .0001), mindfulness (P < .0001), positive affect (P < .0001) and coping (P < .0001) were associated with higher resilience. Depression (P = .23) and anxiety (P = .34) were not. A model of resilience which included gratitude, mindfulness, positive affect and coping as determinants of resilience and perceived stress performed well (RMSEA = .03, SRMR = .02, CFI = .99; TLI = .99). Conclusions The CES was validated in a large sample. The association of gratitude, mindfulness, positive affect and coping with resilience may guide practitioners seeking to design resilience-enhancing programs.
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Affiliation(s)
- James Groves
- Department of Social and Behavioral Sciences, Harvard University Harvard T. H. Chan School of Public Health, Cambridge, MA, USA,James Groves, Department of Social and Behavioral Sciences, Harvard University Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Cambridge, MA 02138, USA. ;
| | - Christina Luberto
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, USA,Benson-Henry Institute, Massachusetts General Hospital, Boston, MA, USA,Health Promotion and Resiliency Intervention Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Gregory Fricchione
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, USA,Benson-Henry Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Elyse Park
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, USA,Benson-Henry Institute, Massachusetts General Hospital, Boston, MA, USA,Health Promotion and Resiliency Intervention Research Program, Massachusetts General Hospital, Boston, MA, USA
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4
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Suntai Z, White B. Social isolation among older veterans: findings from the National Health and Aging Trends Study. Aging Ment Health 2022; 26:1345-1352. [PMID: 34192481 DOI: 10.1080/13607863.2021.1942434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Social isolation is a critical public health issue that affects multiple domains of well-being among older adults, but little is known about social isolation among older military veterans. As such, the purpose of this study was to estimate the prevalence of social isolation among older veterans and to examine risk factors for social isolation among older veterans. METHOD Data were derived from Round 1 of the National Health and Aging Trends Study, which is an annual, longitudinal panel survey of Medicare beneficiaries aged 65 and older. The sample included 1,683 veterans, who were primarily White and male. Weighted logistic regression models were used to predict severe social isolation (having no social participation) and social isolation (having only one source of social participation) among older veterans, while controlling for age, sex, race, marital status, education, income, and metropolitan residency. RESULTS After accounting for other predictors, results show that veterans who are 85 and older, male, White, unmarried or unpartnered, with lower educational attainment and lower income are greatly at risk of both severe social isolation and social isolation. CONCLUSION The results of this study support past research showing that veterans with limited social and economic capital are at great risk of experiencing adverse outcomes in older adulthood, including social isolation. Interventions should therefore aim to improve social connectedness among this population and should address the risk-factors that contribute to social isolation among older veterans.
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Affiliation(s)
- Zainab Suntai
- School of Social Work, Social Work, University of Alabama, Tuscaloosa, AL, USA
| | - Bethany White
- School of Social Work, Samford University, Birmingham, AL, USA
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5
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Rakesh G, Clausen AN, Buckley MN, Clarke-Rubright E, Fairbank JA, Wagner HR, Morey RA. The role of trauma, social support, and demography on veteran resilience. Eur J Psychotraumatol 2022; 13:2058267. [PMID: 35599980 PMCID: PMC9116243 DOI: 10.1080/20008198.2022.2058267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Historically, resilience has often been conceptualized as the sustained lack of symptoms following trauma exposure. In line with a novel conceptualization of resilience as being dynamic over lifespan, determined by interacting biological and environmental factors, we examined the VA Mid-Atlantic Post Deployment Mental Health Repository (PDMH) comprised of 3876 US Military Veterans with and without PTSD diagnoses. METHODS We performed regression modelling to study the relationship between resilience (measured with Connor Davidson Resilience Scale; CD-RISC), posttraumatic stress disorder (PTSD) severity (Davidson Trauma Scale; DTS), social support (Medical Outcome Study Social Support Survey; MOSSS), combat exposure (Combat Exposure Scale; CES), childhood trauma (Trauma Life Events Questionnaire; TLEQ), and demographic factors. CD-RISC was positively correlated with years of education and negatively correlated with DTS, CES and TLEQ scores. RESULTS We found an interaction between CD-RISC and CES in predicting PTSD severity (Davidson Trauma Scale). Specifically, high resilience predicted lower PTSD symptom severity than low resilience, this relationship was amplified with increasing levels of combat exposure. Structural equation modelling (SEM) identified an optimal latent variable that represents resilience and relationships between latent variables for resilience, trauma, and illness. We derived a resilience latent variable composed of age, education level, MOSSS and race. CONCLUSIONS Our results support a conceptualization of resilience as a multifactorial determinant that coexists with PTSD, a state rather than trait variable, and can be quantified by biological and behavioural metrics. HIGHLIGHTS • Historically, resilience has often been conceptualized as the sustained lack of symptoms following trauma exposure.• We examined the VA Mid-Atlantic Post Deployment Mental Health Repository (PDMH) comprised of 3876 US Military Veterans.• We found an interaction effect between CD-RISC and CES in predicting PTSD severity (Davidson Trauma Scale).
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Affiliation(s)
- Gopalkumar Rakesh
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA
| | - Ashley N Clausen
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA
| | - Mary Nicole Buckley
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA
| | - Emily Clarke-Rubright
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA
| | - John A Fairbank
- Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Henry Ryan Wagner
- Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | | | - Rajendra A Morey
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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6
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Resilience, Physical Activity, and Depression in Women Living With HIV in the San Francisco Bay Area. J Assoc Nurses AIDS Care 2021; 33:202-210. [DOI: 10.1097/jnc.0000000000000292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Schuman DL, Buchanan S, Boehler J, Flaherty C. The suicide of Private Danny Chen: An interpersonal theory perspective. DEATH STUDIES 2021; 46:2467-2476. [PMID: 34486948 DOI: 10.1080/07481187.2021.1972365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Despite considerable prevention and intervention efforts, military suicide rates have increased. Although most research on active-duty military suicide has focused on combat exposure, evidence shows that bullying, hazing, and race are understudied risk factors for military suicide. According to the interpersonal theory of suicide, thwarted belongingness, perceived burdensomeness, and acquired capability are necessary components for enacting a suicide death. In this theoretically-based interpersonal case analysis of the suicide death of Private Danny Chen, an American soldier of Chinese descent, we explore how bullying, hazing, and race may have intersected with other vulnerabilities to result in his death.
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Affiliation(s)
- Donna L Schuman
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Steven Buchanan
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | - Jason Boehler
- School of Social Work, Florida State University, Tallahassee, FL, USA
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8
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Park CL, Sacco SJ, Finkelstein-Fox L, Sinnott SM, Scoglio AAJ, Lee SY, Gnall KE, Mazure C, Shirk SD, Hoff RA, Kraus SW. Post-9/11 military veterans' adjustment to civilian life over time following separation from service. J Clin Psychol 2021; 77:2077-2095. [PMID: 33871869 DOI: 10.1002/jclp.23144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/18/2021] [Accepted: 03/25/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVES US military veterans face many challenges in transitioning to civilian life; little information is available regarding veterans' reintegration experiences over time. The current study characterized veterans' postdeployment stressful life events and concurrent psychosocial wellbeing over one year and determined how stressors and wellbeing differ by demographic factors. METHODS Recent Post-911 veterans (n = 402) were assessed approximately every three months for 1 year. Participants were 60% men, primarily White (78%), and 12% Latinx; the average age was 36 years. RESULTS The frequency of stressful events decreased over time but was higher for men and minority-race veterans (independent of time since separation). Veterans reported high mean levels of posttraumatic stress disorder, anxiety, and insomnia symptoms, which improved slightly over time. Minority-race and Latinx veterans had higher symptom levels and slower rates of symptom reduction. CONCLUSION Veterans remain distressed in their overall transition to civilian life. Interventions to promote resilience and help veterans manage readjustment to civilian life appear urgently needed.
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Affiliation(s)
- Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Shane J Sacco
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Sinead M Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Arielle A J Scoglio
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts, USA
| | - Sharon Y Lee
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Katherine E Gnall
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Carolyn Mazure
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Steven D Shirk
- Division of Addiction, VISN1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital and University of Massachusetts Medical School, Bedford, Massachusetts, USA
| | - Rani A Hoff
- Northeast Program Evaluation Center (NEPEC), VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
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9
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Zalta AK, Tirone V, Orlowska D, Blais RK, Lofgreen A, Klassen B, Held P, Stevens NR, Adkins E, Dent AL. Examining moderators of the relationship between social support and self-reported PTSD symptoms: A meta-analysis. Psychol Bull 2021; 147:33-54. [PMID: 33271023 PMCID: PMC8101258 DOI: 10.1037/bul0000316] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Social support is one of the most robust predictors of posttraumatic stress disorder (PTSD). Yet, little is known about factors that moderate the relationship between social support and PTSD symptom severity. This meta-analysis estimated the overall effect size of the relationship between self-reported social support and PTSD severity and tested meaningful demographic, social support, and trauma characteristics that may moderate this association using both cross-sectional and longitudinal effect sizes. A comprehensive search identified 139 studies with 145 independent cross-sectional effect sizes representing 62,803 individuals and 37 studies with 38 independent longitudinal effect sizes representing 25,792 individuals. Study samples had to comprise trauma-exposed, nonclinical adult populations to be included in the analysis. Cross-sectional and longitudinal analyses revealed a near medium overall effect size (rcross = -.27; 95% CI [-.30, -.24]; rlong = -.25; 95% CI [-.28, -.21]) with a high degree of heterogeneity (cross-sectional I2 = 91.6, longitudinal I2 = 86.5). Both cross-sectional and longitudinal moderator analyses revealed that study samples exposed to natural disasters had a weaker effect size than samples exposed to other trauma types (e.g., combat, interpersonal violence), studies measuring negative social reactions had a larger effect size than studies assessing other types of social support, and veteran samples revealed larger effect sizes than civilian samples. Several other methodological and substantive moderators emerged that revealed a complex relationship between social support and PTSD severity. These findings have important clinical implications for the types of social support interventions that could mitigate PTSD severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Vanessa Tirone
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI
| | | | - Ashton Lofgreen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Brian Klassen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Philip Held
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Natalie R. Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Elizabeth Adkins
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Amy L. Dent
- Department of Psychological Science, University of California, Irvine, Irvine, CA
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10
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Blais RK, Tirone V, Orlowska D, Lofgreen A, Klassen B, Held P, Stevens N, Zalta AK. Self-reported PTSD symptoms and social support in U.S. military service members and veterans: a meta-analysis. Eur J Psychotraumatol 2021; 12:1851078. [PMID: 34992740 PMCID: PMC8725779 DOI: 10.1080/20008198.2020.1851078] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The mental health burden of posttraumatic stress disorder (PTSD) is high in U.S. military samples. Social support is one of the most robust protective factors against PTSD and a recent meta-analysis indicates that this relationship is even stronger in military samples compared to civilian samples. Yet no meta-analyses have explored factors impacting this association in veterans and military service members (VSMs). Objective: The current meta-analysis examined demographic, social support, and military characteristics that may moderate the relationship of PTSD severity and social support among U.S. VSMs. Method: A search identified 37 cross-sectional studies, representing 38 unique samples with a total of 18,766 individuals. Results: The overall random effects estimate was -.33 (95% CI: -.38, -.27, Z = -10.19, p <.001), indicating that lower levels of social support were associated with more severe PTSD symptoms. PTSD measures based on the Diagnostic and Statistical Manual (DSM)-III had a larger effect size than measures based on DSM-IV or DSM-5. The social support source was a significant moderator such that support perceived from non-military sources was associated with a larger effect size than support perceived from military sources. This finding held after accounting for covariates. Deployment-era, timing of social support, and age were also significant moderators, but were no longer significantly associated with effect size after adjusting for covariates. Although previous meta-analyses have shown social negativity to be more impactful than positive forms of social support, there were too few studies conducted to evaluate social negativity in moderator analyses. Conclusion: Results suggest that social support received from civilians and in the home environment may play a greater protective role than social support received from military sources on long-term PTSD symptom severity. The literature on social support and PTSD in U.S. VSMs would be strengthened by studies examining the association of social negativity and PTSD symptoms.
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Affiliation(s)
- Rebecca K Blais
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Vanessa Tirone
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI, USA
| | - Ashton Lofgreen
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Brian Klassen
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Philip Held
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Natalie Stevens
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Alyson K Zalta
- Department of Psychological Science, University of California Irvine, Irvine, CA, USA
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11
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Herbert MS, Hernandez J, Dochat C, Pittman JOE, Afari N. Ethnic Differences in the Association Between Pain and Social Support in Iraq and Afghanistan Veterans. PAIN MEDICINE 2020; 21:3066-3072. [PMID: 32022888 DOI: 10.1093/pm/pnz374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Although past research has identified differences in pain between non-Latino white (NLW) and Latino persons, few studies have focused on the influence of social support. The purpose of the present study was to determine if the association between the number of social support sources and ratings of pain intensity and pain interference differed as a function of ethnicity. DESIGN Cross-sectional. SETTING Veterans Affairs San Diego Healthcare System. SUBJECTS Participants were NLW (N = 389) and Latino (N = 207) Iraq and Afghanistan veterans. METHODS Linear regression analyses were used to examine the interaction between ethnicity and number of social support sources on pain intensity and pain interference as measured by the Patient-Reported Outcomes Measurement Information System pain inventory. RESULTS The association between number of social support sources and pain intensity and interference significantly differed by ethnicity (P < 0.01 and P = 0.01, respectively). Among NLW veterans, there was a significant negative association between number of social support sources and pain intensity. Among Latino veterans, there was a significant positive association between number of social support sources and pain intensity and interference. CONCLUSIONS These findings suggest important differences between NLW and Latino Iraq and Afghanistan veterans in the association between social support and pain. Future research should examine ethnic differences in pain-specific support received from the social environment.
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Affiliation(s)
- Matthew S Herbert
- VA San Diego Healthcare System, San Diego, California.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California.,Department of Psychiatry, University of California, San Diego, California
| | | | - Cara Dochat
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - James O E Pittman
- VA San Diego Healthcare System, San Diego, California.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California.,Department of Psychiatry, University of California, San Diego, California
| | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, California.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California.,Department of Psychiatry, University of California, San Diego, California
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12
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Heroes in crisis: Trauma centers should be screening for and intervening on posttraumatic stress in our emergency responders. J Trauma Acute Care Surg 2020; 89:132-139. [DOI: 10.1097/ta.0000000000002671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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13
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Reyes AT, Constantino RE, Cross CL, Tan RA, Bombard JN, Acupan AR. Resilience and psychological trauma among Filipino American women. Arch Psychiatr Nurs 2019; 33:177-185. [PMID: 31753225 DOI: 10.1016/j.apnu.2019.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/10/2019] [Accepted: 08/18/2019] [Indexed: 11/28/2022]
Abstract
AIMS To explore the types of traumatic exposure, prevalence of posttraumatic stress disorder (PTSD), and level of resilience in a community sample of Filipino American women (FAW), as well as to investigate the relationships between their PTSD symptoms, history of traumatic exposure, and resilience. METHOD A cross-sectional study with a total of 188 adult FAW. RESULTS We observed high levels of resilience and low levels of PTSD symptom severity. The most common form of traumatic exposure was non-interpersonal trauma occurring after the age of 18 years old. We also found a significant correlation between history of traumatic exposure and PTSD and between resilience and PTSD. Resilience was found to have a significant moderating effect on the relationship between traumatic exposure and PTSD. CONCLUSIONS The results provide preliminary evidence on the buffering and protective properties of FAW's resilience to PTSD despite traumatic exposure.
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Affiliation(s)
| | - Rose E Constantino
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chad L Cross
- School of Medicine and School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | | | - Judzia N Bombard
- School of Nursing, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Alvin Ryan Acupan
- School of Nursing, University of Nevada Las Vegas, Las Vegas, NV, USA
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Bartley EJ, Hossain NI, Gravlee CC, Sibille KT, Terry EL, Vaughn IA, Cardoso JS, Booker SQ, Glover TL, Goodin BR, Sotolongo A, Thompson KA, Bulls HW, Staud R, Edberg JC, Bradley LA, Fillingim RB. Race/Ethnicity Moderates the Association Between Psychosocial Resilience and Movement-Evoked Pain in Knee Osteoarthritis. ACR Open Rheumatol 2019; 1:16-25. [PMID: 31777776 PMCID: PMC6858004 DOI: 10.1002/acr2.1002] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective Racial/ethnic disparities in pain are well‐recognized, with non‐Hispanic blacks (NHBs) experiencing greater pain severity and pain‐related disability than non‐Hispanic whites (NHWs). Although numerous risk factors are posited as contributors to these disparities, there is limited research addressing how resilience differentially influences pain and functioning across race/ethnicity. Therefore, this study examined associations between measures of psychosocial resilience, clinical pain, and functional performance among adults with knee osteoarthritis (OA), and assessed the moderating role of race/ethnicity on these relationships. Methods In a secondary analysis of the Understanding Pain and Limitations in Osteoarthritic Disease (UPLOAD‐2) study, 201 individuals with knee OA (NHB = 105, NHW = 96) completed measures of resilience (ie, trait resilience, optimism, positive well‐being, social support, positive affect) and clinical pain, as well as a performance‐based measure assessing lower‐extremity function and movement‐evoked pain. Results Bivariate analyses showed that higher levels of psychosocial resilience were associated with lower clinical pain and disability and more optimal physical functioning. NHBs reported greater pain and disability, poorer lower‐extremity function, and higher movement‐evoked pain compared with NHWs; however, measures of psychosocial resilience were similar across race/ethnicity. In moderation analyses, higher optimism and positive well‐being were protective against movement‐evoked pain in NHBs, whereas higher levels of positive affect were associated with greater movement‐evoked pain in NHWs. Conclusion Our findings underscore the importance of psychosocial resilience on OA‐related pain and function and highlight the influence of race/ethnicity on the resilience‐pain relationship. Treatments aimed at targeting resilience may help mitigate racial/ethnic disparities in pain.
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Affiliation(s)
- Emily J Bartley
- University of Florida, Pain Research and Intervention Center of Excellence Gainesville Florida
| | | | | | - Kimberly T Sibille
- University of Florida, Pain Research and Intervention Center of Excellence Gainesville Florida
| | - Ellen L Terry
- University of Florida, Pain Research and Intervention Center of Excellence Gainesville Florida
| | - Ivana A Vaughn
- University of Florida, Pain Research and Intervention Center of Excellence Gainesville Florida
| | - Josue S Cardoso
- University of Florida, Pain Research and Intervention Center of Excellence Gainesville Florida
| | - Staja Q Booker
- University of Florida, Pain Research and Intervention Center of Excellence Gainesville Florida
| | | | | | | | | | | | - Roland Staud
- University of Florida, Pain Research and Intervention Center of Excellence Gainesville Florida
| | | | | | - Roger B Fillingim
- University of Florida, Pain Research and Intervention Center of Excellence Gainesville Florida
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