Longitudinal associations between mental health and social environment in older adults: a multilevel growth modeling

OBJECTIVES

This study aimed to assess longitudinal relationships between social environment indicators (social connectedness, social engagement, social contribution) and mental health indicators (depression and anxiety) among community-dwelling adults age 55 years and older.

METHODS

Data were drawn from 3-waves of the national longitudinal survey of Midlife Development in the United States (MIDUS) (N = 2,020; age range = 55-94 years). We developed multilevel growth models to ascertain the relationships of interest, controlling for sociodemographic and physical health factors.

RESULTS

Over the 20-year period of study, lower levels of emotional social support, social integration and social contribution significantly predicted depression and anxiety, whereas social network and social engagement were not significant predictors of these mental health outcomes in older adults. The models also indicated a moderation effect of the number of chronic conditions on the slopes of depression and anxiety.

DISCUSSION

Considering our findings, interventions to enhance social contribution and social connectedness could be effective to help older adults maintain positive mental health, as well as programs that facilitate older adults' connections with their families, communities and health care providers. These interventions must also account for multiple chronic conditions since functional limitations drive declining integration in the community and participation in social activities.

The More, the Better? Social Capital Profiles and Adolescent Internalizing Symptoms: A Latent Profile Analysis

Past research suggests that offline and online social capital are empirically linked to adolescent psychological adjustment. However, little is known regarding the implications of distinctive combinations of social capital for adolescent internalizing symptoms. The present study aimed to examine adolescent social capital patterns and their associations with internalizing symptoms by using latent profile analysis. A cross-sectional web-based survey was conducted among 1595 Chinese adolescents (mean age = 14.30 years, 50.7% male). All adolescents completed self-report questionnaires on their perceived offline and online social capital, depressive symptoms and anxiety symptoms. Latent profile analysis revealed four profiles of social capital: (1) Low Social Capital, (2) Moderate Social Capital, (3) High Social Capital, and (4) Only High Offline Social Capital. Further, analysis of covariance demonstrated that the Only High Offline Social Capital profile had significantly fewer internalizing symptoms than other three profiles. No statistical differences of internalizing symptoms were found between the other three profiles, except that the Moderate Social Capital profile showed fewer anxiety symptoms than the Low Social Capital profile. These findings suggest that more social capital does not equal to better mental health status. The social capital profiles and their associations with adolescent internalizing symptoms may provide practitioners with meaningful implications regarding the role of offline and online social capital in adolescent psychological adjustment.

Did States With More Social Capital Pre-pandemic Offer Mental Health Protection During the COVID-19 Pandemic? A Cross-Sectional View

Background

Social capital is a well-known health determinant with both relational and geographic aspects. It can help mitigate adverse events and has been shown to impact behaviors and responses during the COVID-19 pandemic. Mental health has declined during the COVID-19 pandemic, and social capital, may serve to buffer those declines.

Methods

Building from this, we assessed whether pre-pandemic social capital and contemporaneous social policy, which included indicators of social trust, civic participation, and presence of mask mandates, affected pandemic mental health, measured as the percent of the population experiencing symptoms of depression and anxiety at the state level.

Results

Generalized social trust and state mask mandates were significantly associated with lower levels of depression and anxiety. Conversely, states with greater civic engagement prior to the pandemic experienced more anxiety and depression.

Conclusions

Findings suggest that existing social capital, particularly social trust, may protect against anxiety and depression and contribute to community resilience during times of adversity. States should invest in policies and programs that increase social trust.

Parent and Peer Attachments in Adolescence and Paternal Postpartum Mental Health: Findings From the ATP Generation 3 Study

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.

Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum (N = 409 infant offspring) for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.

Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.

Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems.

Associations between personal social capital and depressive symptoms: Evidence from a probability sample of urban residents in China

BACKGROUND:

Rapid socioeconomic changes in China present a mental health challenge and also an opportunity to investigate the relationship between social capital and depression.

MATERIALS AND METHODS:

Participants (18-45 years old, N = 1,250) were selected using a probability sampling method. The relationship between social capital (measured using the Personal Social Capital Scale) and depression (measured using the Brief Symptom Inventory Depression Subscale) was examined using bivariate analysis, followed by multiple regression to control for covariates.

RESULTS:

Of the total sample, 54.64% were female with mean age = 35.1 (standard deviation ( SD) = 7.5) years old. Depression score was 10.40 ( SD = 3.62) for males and 10.36 ( SD) = 3.30) for females. The social capital measures (including the total, bonding and bridging) were all negatively associated with depression scores, while the negative social capital was positively associated, after controlling for covariates. Subgroup analysis revealed some differences in the social capital-depression associations.

CONCLUSION:

The protective effect of social capital for mental health reported in other countries is also evident in this study. In addition, we found a positive association between negative social capital and depression. In addition to adding new knowledge, findings of this study, if verified with longitudinal design, can be used to support social and behavioral interventions in China to promote mental health by social capital enhancement.

Bidirectional predictions between Internet addiction and probable depression among Chinese adolescents

BACKGROUND AND AIMS

The aim of the study is to investigate (a) whether probable depression status assessed at baseline prospectively predicted new incidence of Internet addiction (IA) at the 12-month follow-up and (b) whether IA status assessed at baseline prospectively predicted new incidence of probable depression at follow-up.

METHODS

We conducted a 12-month cohort study (n = 8,286) among Hong Kong secondary students, and derived two subsamples. The first subsample (n = 6,954) included students who were non-IA at baseline, using the Chen Internet Addiction Scale (≤63), and another included non-depressed cases at baseline (n = 3,589), using the Center for Epidemiological Studies Depression Scale (<16).

RESULTS

In the first subsample, 11.5% of the non-IA cases developed IA during follow-up, and probable depression status at baseline significantly predicted new incidence of IA [severe depression: adjusted odds ratio (ORa) = 2.50, 95% CI = 2.07, 3.01; moderate: ORa = 1.82, 95% CI = 1.45, 2.28; mild: ORa = 1.65, 95% CI = 1.32, 2.05; reference: non-depressed], after adjusting for sociodemographic factors. In the second subsample, 38.9% of those non-depressed participants developed probable depression during follow-up. Adjusted analysis showed that baseline IA status also significantly predicted new incidence of probable depression (ORa = 1.57, 95% CI = 1.18, 2.09).

DISCUSSION AND CONCLUSIONS

The high incidence of probable depression is a concern that warrants interventions, as depression has lasting harmful effects in adolescents. Baseline probable depression predicted IA at follow-up and vice versa, among those who were free from IA/probable depression at baseline. Healthcare workers, teachers, and parents need to be made aware of this bidirectional finding. Interventions, both IA and depression prevention, should thus take both problems into consideration.

Preparing parents for parenthood: protocol for a randomized controlled trial of a preventative parenting intervention for expectant parents

Background

Becoming the parent of a new baby comes with a range of challenges including difficulties with emotional adjustment, couple relationship issues and difficulty managing common infant behaviors, such as crying and sleep problems. This time can be especially challenging for couples who experience a range of risk factors. Previous parenting interventions for parents of babies have shown mixed results. This protocol paper describes a randomized controlled trial of a group-based parenting intervention for high-risk parents expecting their first baby.

Methods/design

Participants will be randomized to either Group Baby Triple P or Care as Usual (CAU). Group Baby Triple P involves 4 × 2 h group sessions delivered during pregnancy and 4 individual telephone sessions of 30 min each in the early postnatal period. Outcomes will be assessed via parent self-report questionnaire, home observations and a baby diary 10 weeks and 6 months post-birth. Primary outcomes will be parental confidence and perceived competence. Secondary outcomes will include parental responsiveness and bonding with the baby, relationship happiness, life satisfaction, depression, anxiety and stress, and infant crying and sleep. Analyses will involve a series of rANOVA and rMANOVAs, t-tests and a multilevel modeling approach.

Discussion

A brief summary, strengths and potential implications are discussed.

Trial registration

Australian New Zealand Clinical Trials Registry: ANZCTR 12613000948796. Registered 27 August, 2013.

Disentangling the directions of associations between structural social capital and mental health: Longitudinal analyses of gender, civic engagement and depressive symptoms

The present paper analysed the directions of associations between individual-level structural social capital, in the form of civic engagement, and depressive symptoms across time from age 16-42 years in Swedish men and women. More specifically, we asked whether civic engagement was related to changes in depressive symptoms, if it was the other way around, or whether the association was bi-directional. This longitudinal study used data from a 26-year prospective cohort material of 1001 individuals in Northern Sweden (482 women and 519 men). Civic engagement was measured by a single-item question reflecting the level of engagement in clubs/organisations. Depressive symptoms were assessed by a composite index. Directions of associations were analysed by means of gender-separate cross-lagged structural equation models. Models were adjusted for parental social class, parental unemployment, parental health, and family type at baseline (age 16). Levels of both civic engagement and depressive symptoms were relatively stable across time. The model with the best fit to data showed that, in men, youth civic engagement was negatively associated with depressive symptoms in adulthood, thus supporting the hypothesis that involvement in social networks promotes health, most likely through provision of social and psychological support, perceived influence, and sense of belonging. Accordingly, interventions to promote civic engagement in young men could be a way to prevent poor mental health for men later on in life. No cross-lagged effects were found among women. We discuss this gender difference in terms of gendered experiences of civic engagement which in turn generate different meanings and consequences for men and women, such as civic engagement not being as positive for women's mental health as for that of men. We conclude that theories on structural social capital and interventions to facilitate civic engagement for health promoting purposes need to acknowledge gendered life circumstances.

Social capital and common mental disorder: a systematic review

OBJECTIVE

This study aims to systematically review all published quantitative studies examining the direct association between social capital and common mental disorders (CMD). Social capital has potential value for the promotion and prevention of CMD. The association between different types of social capital (individual cognitive and structural, and ecological cognitive and structural) and CMD must be explored to obtain conclusive evidence regarding the association, and to ascertain a direction of causality.

DESIGN

10 electronic databases were searched to find studies examining the association between social capital and CMD published before July 2014. The effect estimates and sample sizes for each type of social capital were separately analysed for cross-sectional and cohort studies. From 1857 studies retrieved, 39 were selected for inclusion: 31 cross-sectional and 8 cohort studies. 39 effect estimates were found for individual level cognitive, 31 for individual level structural, 9 for ecological level cognitive and 11 for ecological level structural social capital.

MAIN RESULTS

This review provides evidence that individual cognitive social capital is protective against developing CMD. Ecological cognitive social capital is also associated with reduced risk of CMD, though the included studies were cross-sectional. For structural social capital there was overall no association at either the individual or ecological levels. Two cross-sectional studies found that in low-income settings, a mother's participation in civic activities is associated with an increased risk of CMD.

CONCLUSIONS

There is now sufficient evidence to design and evaluate individual and ecological cognitive social capital interventions to promote mental well-being and prevent CMD.

Measuring Social Capital Investment: Scale Development and Examination of Links to Social Capital and Perceived Stress

Individuals with greater social capital have better health outcomes. Investment in social capital likely increases one's own social capital, bearing great implications for disease prevention and health promotion. In this study, the authors developed and validated the Social Capital Investment Inventory (SCII). Direct effects of social capital investment on perceived stress, and indirect effects through social capital were examined. 397 Participants from Beijing and Wuhan, China completed surveys. Analyses demonstrated that the SCII has a single factor structure and strong internal consistency. Structural equation modeling showed that individuals who invested more in social capital had greater bonding social capital, and subsequently less perceived stress. Results suggest that disease prevention and health promotion programs should consider approaches to encourage social capital investment; individuals may be able to reduce stress by increasing their investment in social capital. Future research is needed to provide additional empirical support for the SCII and observed structural relationships.

Developmental antecedents of abnormal eating attitudes and behaviors in adolescence

OBJECTIVE

This study capitalizes on developmental data from an Australian population-based birth cohort to identify developmental markers of abnormal eating attitudes and behaviors in adolescence. The aims were twofold: (1) to develop a comprehensive path model identifying infant and childhood developmental correlates of Abnormal Eating Attitudes and Behaviors in adolescence, and (2) to explore potential gender differences.

METHOD

Data were drawn from a 30-year longitudinal study that has followed the health and development of a population based cohort across 15 waves of data collection from infancy since 1983: The Australian Temperament Project. Participants in this analysis were the 1,300 youth who completed the 11th survey at 15-16 years (1998) and who completed the eating disorder inventory at this time point.

RESULTS

Developmental correlates of Abnormal Eating Attitudes and Behaviors in mid-adolescence were temperamental persistence, early gestational age, persistent high weight, teen depression, stronger peer relationships, maternal dieting behavior, and pubertal timing. Overall, these factors accounted for 28% of the variance in Abnormal Eating Attitudes and Behaviors at 15-16 years of age. Depressive symptoms, maternal dieting behavior, and early puberty were more important factors for girls. Late puberty was a more important factor for boys.

DISCUSSION

Findings address an important gap in our understanding of the etiology of Abnormal Eating Attitudes and Behaviors in adolescence and suggest multiple targets for preventive intervention.

A multilevel analysis of association between neighborhood social capital and depression: evidence from the first South African National Income Dynamics Study

BACKGROUND

As neuropsychiatric disorders account for a great proportion of the total burden of disease in sub-Saharan Africa, depression is rapidly emerging as a public health issue in South Africa. Given the divisions enforced by a legacy of the apartheid spatial and economic policies, features of communities such as neighborhood-level social capital may play a critical role in depression. However, the extent to which neighborhood-level social capital is associated with depression in South Africa at the population-level is unknown.

METHODS

Data from the first wave of the South African National Income Dynamics Study (SA-NIDS) was used to examine the association between the neighborhood-level social capital and individual depression using multilevel regression models.

RESULTS

There was a negative association between neighborhood-level social capital and depression score with social trust and neighborhood preference accounting for this association. Structural social capital, namely civic participation, was not related to depression. Individual predictors, including social class, self-rated health status and education, were strong covariates of depression.

LIMITATIONS

The cross-sectional design of the study limits our understanding of the temporal order of social capital and depression.

CONCLUSIONS

In post-apartheid South Africa, low social capital remains an important social determinant of health, including depression outcome. This is in addition to individual determinants related to class such as unemployment, education and social class which play an important role in influencing depression. Further research utilizing a longitudinal study design is warranted to examine the association between social capital and depression in South Africa.