Personal networks and associations with psychological distress among young and older adults

Confidants and Caregivers: Network Multiplexity and Subjective Well-Being of Older Adults

OBJECTIVES

Older adults rely on personal networks for different types of support. Given shifts in family composition in later adulthood, more work is needed to map network members who can provide multiple aspects of support and the implications for older adults. We explore the phenomenon of having the same network members as both a confidant and a caregiver (multiplexity) and its implications for the well-being of older adults.

METHODS

Using the 2011 National Health and Aging Trends Study, we describe the prevalence of having someone as both a confidant and a caregiver (henceforth "multiplex helper") for older adults and examine its association with subjective well-being. We also investigate the differences by having whom as multiplex helpers.

RESULTS

About three-quarters (76%) of older adults with at least 1 confidant and 1 caregiver have at least 1 multiplex helper. Partnered older adults are more likely to have any multiplex helpers than unpartnered counterparts and usually nominate their partner as a multiplex helper, whereas the unpartnered are more likely to rely on their children to serve multiple roles, especially for widowed older adults. Having a multiplex helper is associated with better subjective well-being.

DISCUSSION

Network multiplexity is prevalent and positively associated with the subjective well-being of older adults who have at least 1 confidant and 1 caregiver, above and beyond having any confidants or caregivers separately. The baseline patterns established in this study lay the groundwork for future research to further explore support dynamics in older adults' networks.

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.

Understanding community-dwelling older adults' preferences for home- and community-based services: A conjoint analysis

BACKGROUND

Older adults' preference for home- and community-based service programs has been highlighted as an essential but usually ignored ingredient in current care models. Disentangling how preferences contribute to older adults' decision-making could facilitate finding optimal ways to deliver home- and community-based services in times of increasing scarcity.

OBJECTIVE

To identify Chinese community-dwelling older adults' preference structure for home- and community-based services and thus to optimize service provision.

METHODS

Conjoint analysis, a preference-based technique, was employed to study older adults' preferences. A stepwise qualitative approach was first adopted to identify the attributes and attribute levels of home- and community-based services. Scenarios were defined through an orthogonal fractional factorial design, and a cross-sectional survey was conducted through a face-to-face, anonymous questionnaire. Conjoint analysis was performed to determine preference weights representing the relative importance of the identified attributes, and cluster analysis was performed to identify clusters of participants with similar preference structures. All data analyses were performed using SAS v9.4 and SPSS 22.0.

RESULTS

A total of 321 of 350 invited participants completed the questionnaire. Four attributes were identified and used to create the conjoint scenarios: care-giving attitude, price, technical care-giving skills, and the type of service provider. Care-giving attitude was the most valued attribute for older adults when making decisions (relative importance score = 48.28), followed by price (relative importance score = 21.618), technical care-giving skills (relative importance score = 19.518), and finally, the type of service provider (relative importance score = 10.585). Three preference phenotypes were identified by applying cluster analysis: "price-oriented", "comprehensively balanced", and "attitude-oriented".

CONCLUSION

The present study underscored the importance of considering attributes valued by Chinese older adults in the design and delivery of home- and community-based services. The preference structure, including the utility score of the attribute levels, differs among older adults. The findings could inform future research and practice and suggest incorporating flexibility during the service delivery stage.

Who Gets Help? A National Longitudinal Study of Personal Networks and Pandemic Support Among Older Adults

OBJECTIVES

Personal networks provide social support for older adults, perhaps especially during the coronavirus disease 2019 (COVID-19) pandemic when traditional avenues may be disrupted. We provide one of the first population-based studies on how prepandemic personal networks predict support during the pandemic among older adults, with attention to gender and race variation.

METHOD

We analyzed longitudinal data from the National Social Life, Health, and Aging Project Round 3 (2015/2016) and COVID-19 Round (2020; N = 2622, 55.68% female, 78.75% White, aged 50-99), a nationally representative survey of community-dwelling older Americans. We considered structure (i.e., size, density) and composition (i.e., proportion female and kin) of prepandemic personal networks, estimating multinomial logistic models to predict self-reported need and receipt of instrumental help and emotional support during the pandemic.

RESULTS

Larger prepandemic confidant networks predicted higher risk of receiving needed pandemic help and support, higher risk of receiving help and support more often than prepandemic, and lower risk of being unable to get help. Denser prepandemic networks also predicted higher risk of receiving pandemic help and support. Furthermore, how network size and density related to support differed with respondent race and a greater proportion of kin in prepandemic networks predicted higher risk of receiving help for non-White older adults only.

DISCUSSION

Older adults' prepandemic confidant network structure and composition can provide underlying conditions for receiving pandemic social support. Findings speak to policies and programs that aim to foster social support or identify vulnerable groups that suffer the greatest unmet need for support during a global crisis.

Personal network protects, social media harms: Evidence from two surveys during the COVID-19 pandemic

Background

The classic debate regarding the complex relationships between personal network, social media use, and mental well-being requires renewed examination in the novel context of pandemic-related social isolation.

Data and method

We present two surveys conducted at (i) the earlier months of the pandemic and (ii) the end of large scale social-lockdown measures in the U.S. to explore the social and behavioral antecedents of mental health states relating to social media use. Study 1 tracked the longitudinal changes of personal network, social media use, and anxiety level of a group of individuals (N = 147) over a three-month period during the pandemic. Study 2 replicated and extended the theoretical model to a race-representative U.S. adult sample (N = 258).

Results

Both studies consistently show that (1) more time on social media worsens anxiety. It also mediates the relationship between personal network size and anxiety. That is, a small personal network predicts more social media use, which is in turn related to increased anxiety. (2) Moreover, the effect of social media use on anxiety is mainly explained by news consumption on social media, rather than non-news related usage. (3) This link's strength is moderated by one's perception of COVID-19 impact, such that news consumption on social media increases anxiety more when the perceived impact is higher.

Conclusion

These results demonstrate communication technologies' increasingly critical and multifaceted role in affecting mental health conditions.

Life course transitions and changes in network ties among younger and older adults

Several theories of the life course highlight the importance of social connections and ties for coping with transitions that occur at different ages. Individuals rely on family, friends, and colleagues to adapt to these transitions which may in turn change the composition of their networks. Yet, little is known about the association between life cycle transitions and changes in network characteristics. We used fixed effects regression models with three waves of egocentric network data from the UC Berkeley Social Network Study (UCNets) to examine how career- and family-related life cycle transitions during two key life stages-young adulthood and the transition from middle to old age-are associated with network turnover, the proportion of the network comprised of kin, and confidence in receiving support from personal networks. Younger adults experienced churn following a birth and marriage or partnership, while no life transition was associated with changes in proportion kin, and only with the birth of a child did confidence decline. Among older adults, no transition was associated with any measured event, suggesting that older adults maintain more stable relationships compared to young adults and can weather life events without significant disruptions to their networks.

Network Support and Negative Life Events Associated With Chronic Cardiometabolic Disease Outcomes

INTRODUCTION

Stress from negative life events may be an important risk factor for chronic cardiometabolic conditions, which are increasingly prevalent among young adults. Support from personal networks is known to buffer stress from negative life events. Yet, evidence for these relationships among both young and older adults remains unclear.

METHODS

Longitudinal data came from the University of California, Berkeley Social Networks Study (2015-2018), which followed young (aged 21-30 years) and late middle-aged (aged 50-70 years) adults over 4 years. Weighted hybrid fixed and random effects models (completed in 2020) were used to examine the causal relationships among 4 negative life events, distinct forms of network support (e.g., social companionship, emergency help), and self-reported chronic cardiometabolic disease outcomes (i.e., hypertension, diabetes, or a heart condition).

RESULTS

Among young adults, both the death of a close tie (average marginal effect=0.10, p<0.001) and financial difficulties (average marginal effect=0.07, p<0.05) were associated with a higher probability of chronic cardiometabolic outcomes. Higher numbers of confidants (average marginal effect= -0.03, p<0.01) and practical helpers (average marginal effect= -0.02, p<0.01) were associated with a lower probability of chronic cardiometabolic outcomes, whereas higher numbers of social companions were associated with a higher probability of having chronic cardiometabolic outcomes among young adults (average marginal effect=0.02, p<0.01).

CONCLUSIONS

Negative life events may be important risk factors for chronic cardiometabolic disease outcomes, particularly among young adults. Although there is no evidence of network support mediating the effects of negative life events, increases in network support were directly associated with chronic cardiometabolic outcomes.

Social Cost and Health: The Downside of Social Relationships and Social Networks

The research tradition on social relationships, social networks, and health dates back to the beginning of sociology. As exemplified in the classic work of Durkheim, Simmel, and Tönnies, social relationships and social networks play a double-edged-protective and detrimental-role for health. However, this double-edged role has been given unbalanced attention. In comparison to the salubrious role, the deleterious role has received less scrutiny and needs a focused review and conceptual integration. This article selectively reviews the post-2000 studies that demonstrate the harmful physical and mental health consequences of social relationships (intimate relationships and parenthood) and social networks. It uses a parsimonious three-category typology-structural forms, structural composition, and contents-to categorize relationship and network properties and proposes the social cost model, in contrast to the social resource model, to synthesize and integrate the adverse aspects of these properties. It concludes with future research directions.

The Structure of Social Support in Confidant Networks: Implications for Depression

Social support differs for depressed and non-depressed individuals. However, the structural features of social supports, as represented via social networks and how they are related to depression, and its mitigation, are unclear. Here, we examine associations between personal support network structures and self-reports of depression and depression mitigation behaviors. Cross-sectional data were collected from participants (n = 1002 adults) recruited from a research volunteer website. Personal support networks were elicited by asking participants to nominate up to six people (i.e., confidants) that they talk to about interpersonal problems (e.g., unpleasant social encounters) and to indicate who knows whom among their confidants. Results show that the confidant networks of depressed and non-depressed participants did not differ in network size or in constraint-i.e., the degree to which confidants' ties overlap with the ties of the participant. However, depressed participants' confidants had significantly fewer average ties with one another (mean degree). Irrespective of depression diagnosis, lower network constraint and size predicted greater engagement in depression mitigation behaviors. That is, having relatively large confidant networks within which one can freely navigate one's personal information can contribute to improvement in depressive outcomes. Implications are further discussed in the discussion section.

The isolation paradox: A comparative study of social support and health across migrant generations in the U.S

Social isolation and international migration have potentially adverse effects on physical and mental health, and may compound each other when migrants have limited access to supportive social networks. This problem may be particularly serious in older age groups, who are more vulnerable to illness and isolation. We analyze population representative data from a detailed survey of social networks and health in the San Francisco Bay Area, U.S., to compare access to different types of social support and health outcomes among first-generation migrants, second-generation migrants, and nonmigrants between 50 and 70 years old (N = 674). We find that first-generation migrants report systematically lower levels of social support and poorer self-rated health compared to nonmigrants, even after controlling for sociodemographic characteristics. While social support is strongly and positively associated with health in the general population, this relationship is null or, in some cases, reversed among migrants in the first and second generations. These results provide further evidence that migration operates as an adverse social determinant of health, and suggest an isolation paradox: migrants are healthier than nonmigrants only at very low levels of social support, and they do not experience the same beneficial health effects of social support as nonmigrants.

Influence of Subjective/Objective Status and Possible Pathways of Young Migrants' Life Satisfaction and Psychological Distress in China

Young migrants have been the major migrant labor force in urban China. But they may be more vulnerable in quality of life and mental health than other groups, due to their personal characteristic and some social/community policies or management measures. It highlights the need to focus on psychological wellbeing and probe driving and reinforcing factors that influence their mental health. This study aimed to investigate the influence of subjective/objective status and possible pathways of young migrants' life satisfaction and psychological distress. Data on 9838 young migrants in the China Migrants Dynamic Survey were analyzed by LISREL 8.8. A total of 94.03% migrated for jobs or business. Subjective status, including subjective socioeconomic status, social adaptation, and psychological integration, had positive effects on life satisfaction, whereas social adaptation and psychological integration negatively affected psychological distress. Objective status, including objective socioeconomic status and health insurance, had adverse effects on life satisfaction, whereas they positively affected psychological distress. Social participation and city belonging had only significant positive mediating roles on life satisfaction. It is essential to increase social adaptation and decrease integration stress according to younger internal migrants' practical needs. It is also necessary to enhance community/social resources and activities in the context of developing sustainability in the community to assist in mental health promotion.

Best Practices for Modeling Egocentric Social Network Data and Health Outcomes

OBJECTIVE/AIM

We describe best practices for modeling egocentric networks and health outcomes using a five-step guide.

BACKGROUND

Social network analysis (SNA) is common in social science fields and has more recently been used to study health-related topics including obesity, violence, substance use, health organizational behavior, and healthcare utilization. SNA, alone or in conjunction with spatial analysis, can be used to uniquely evaluate the impact of the physical or built environment on health. The environment can shape the presence, quality, and function of social relationships with spatial and network processes interacting to affect health outcomes. While there are some common measures frequently used in modeling the impact of social networks on health outcomes, there is no standard approach to social network modeling in health research, which impacts rigor and reproducibility.

METHODS

We provide an overview of social network concepts and terminology focused on egocentric network data. Egocentric, or personal networks, take the perspective of an individual who identifies their own connections (alters) and also the relationships between alters.

RESULTS

We describe best practices for modeling egocentric networks and health outcomes according to the following five-step guide: (1) model selection, (2) social network exposure variable and selection considerations, (3) covariate selection related to sociodemographic and health characteristics, (4) covariate selection related to social network characteristics, and (5) analytic considerations. We also present an example of SNA.

CONCLUSIONS

SNA provides a powerful repertoire of techniques to examine how relationships impact attitudes, experiences, and behaviors-and subsequently health.

Social networks and health in later life: a state of the literature

Late life is a period frequently marked by decline in personal health and heightened need for social support. Consequently, the social networks in which individuals are embedded assume an increasingly central role in the health and wellbeing of older adults. In the present article, I review the state of the literature on social networks and health in later life. By drawing on insights from the sociology of ageing and the life course, I address new developments and current challenges within the field. Chief among these developments and challenges is the recognition that the ageing process does not occur in a vacuum. Rather, individuals are consistently exposed to numerous changes to their social lives which have strong implications for current and future health outcomes. Upon highlighting the latest innovations within the field of networks and health, I conclude with useful directions for future research.

Interpersonal communication, empathy, and stress perceived by nursing students who use social networks

AIM

The objective of this study was to explore interpersonal communication, empathy, and stress perceived by nursing students who use social networks.

DESIGN

A cross-sectional study was performed.

METHODS

A convenience sample of 135 nursing students. For data collection, the following instruments were used: The WhatsApp Negative Impact Scale, The Perceived Stress Scale, The Interpersonal Communication Competence Inventory, and the Jefferson Scale of Empathy. Data collection took place in February 2020.

RESULTS

A negative correlation was found between the WhatsApp Negative Impact and the Jefferson Scale of Empathy (rs = -0.204; p = .019). Conversely, a positive correlation was also observed between the Interpersonal Communication Competence Inventory and the Jefferson Scale of Empathy (rs = 0.212; p = .014).

CONCLUSION

Nursing students' use of new technology could be problematic and interfere with their therapeutic communication skills.

IMPACT

This study addresses the problem of social network use in the clinical setting and how this can influence nursing students' therapeutic communication skills with patients. The results of this study have showed that, among nursing students, social network use has a negative impact, showing decreased empathy. Likewise, students who show a greater level of empathy have better interpersonal communication skills. However, significant results were not found between psychological distress and problematic social network use. Therefore, it is necessary to perform additional studies that would further explore this aspect. This study allows us to explore the negative impact of social networks on therapeutic communication, with the aim of developing prevention strategies at university institutions.

Giving Voice to the Environment as the Silent Partner in Aging: Examining the Moderating Roles of Gender and Family Structure in Older Adult Wellbeing

Gerontological scholarship has long seen the environment to be a silent partner in aging. Environmental Gerontology, an established approach in Social Gerontology, has shown how the everyday lives of older adults are deeply entangled in socio-spatial environments. Adopting an Environmental Gerontology approach, we explore social and cultural dimensions of the association between out-of-home mobility and wellbeing among older adults in a north western city of India. This was established by combining high resolution time-space data collected using GPS receivers, questionnaire data and time diaries. Following a multi-staged analytical strategy, we first examine the correlation between out-of-home mobility and wellbeing using bivariate correlation. Second, we introduce gender and family structure into regression models as moderating variables to improve the models' explanatory power. Finally, we use our results to reinterpret the Ecological Press Model of Aging to include familial structure as a factor that moderates environmental stress. Findings emphasize the central role that social constructs play in the long-established relationship between the environment and the wellbeing of older adults.