Social context and depression severity and duration in Canadian men and women: exploring the influence of social support and sense of community belongingness

Sense of belonging to community and avoidable hospitalization: a population-based cohort study of 456,415 Canadians

A sense of belonging to a community is a dimension of subjective well-being that is of growing population health interest. We evaluated sex-stratified associations between community belonging and risk of avoidable hospitalization. Adult men and women from the Canadian Community Health Survey (2000-2014) were asked to rate their sense of community belonging (N = 456,415) and were also linked to acute inpatient hospitalizations to 31 March 2018. We used Cox proportional hazards models to assess the association between community belonging and time to hospitalization related to ambulatory care sensitive conditions (ACSCs) and adjusted for a range of sociodemographic, health, and behavioural confounders. Compared to those who reported intermediate levels of belonging, both very weak and very strong sense of belonging were associated with greater risk of avoidable hospitalization for women (HR 1.29, 95% CI 1.12, 1.47, very weak; HR 1.15, 95% CI 1.03, 1.27, very strong), but not for men (HR 1.12, 95% CI 0.97, 1.29, very weak; HR 1.08, 95% CI 0.98, 1.19, very strong). This study suggests that community belonging is associated with risk of ACSC hospitalization for women and provides a foundation for further research on community belonging and population health.

The effect of the sense of Community on Depression, Anxiety, and Stress: the mediation role of a balanced time perspective

PURPOSE

Social context and time are two dimensions within which our entire existence is embedded. Therefore, prompting a positive set of attitudes and beliefs towards these elements is fundamental for individuals' psychological well-being. Currently, there is limited understanding regarding the interplay between the sense of community and time perspective in relation to psychological distress. The present study aims, at investigating the effects that the sense of community and time perspective have on the levels of anxiety, depression, and stress. Particular attention has been dedicated to testing whether the effect of sense of community on anxiety, depression, and stress is mediated by the deviation from a balanced time perspective.

METHODS

To accomplish our purposes, we asked 352 participants to complete an online survey and respond to the Depression, Anxiety, Stress Scale (DASS-21), the Zimbardo Time Perspective Inventory (ZTPI), and the Multi-Dimensional Sense of Community Scale (MTSOCS). From these scales, we obtained the scores for anxiety, depression, and stress as well as a general score for the sense of community and the deviation from a balanced time perspective. We computed three General Linear Mediation Models, one for each scale of the DASS-21.

RESULTS

The results showed that the relationship between sense of community and psychological distress was mediated by the deviation from a balanced time perspective extending previous findings and enriching the existing literature on time perspective.

CONCLUSION

The results described so far could be applied to build a series of interventions aimed at promoting psychological well-being in the general population. Considering our findings, we suggest that individuals' health could be promoted by both improving their sense of community, which in turn would decrease their levels of stress, and by restructuring their time perspective when it became dysfunctional and unbalanced.

Do Municipal Contexts Matter for Adolescent Mental Health? A Within-Municipality Analysis of Nationwide Norwegian Survey Data Across Six Years

Despite growing concerns about substantial socio-economic differences between districts in many developed nations, limited attention has been paid to how adolescent mental health may be shaped by district characteristics. A few studies have shown that adolescent mental health is related to contextual factors such as district socio-economic status, neighborhood disorder, and quality of infrastructure. However, prior estimates may be an artifact of unmeasured differences between districts. To address these concerns, we used data from the nationwide Norwegian Ungdata surveys (N = 278,764), conducted across the years 2014 to 2019. We applied three-level hierarchical linear models to examine within-municipality associations between municipal factors and adolescent mental health in the domains of internalizing problems (i.e., depressive symptoms), externalizing problems (i.e., behavioral problems), and well-being (i.e., self-esteem), thereby accounting for all time-invariant municipality-level confounders. Our results showed that municipal-level safety, infrastructure, and youth culture are associated with adolescent mental health problems. Further, cross-level interaction models indicated gender-specific associations, with stronger associations of municipality infrastructure and community belongingness with increased self-esteem and reduced delinquent behaviors among girls than boys. Our findings highlight that municipality-level interventions may be a feasible strategy for adolescent mental health, even in a society characterized by low inequality and high redistribution.

Analysis of the Influencing Factors of Seeking Intention on COVID-19 Risk Information: A Cross-Sectional Study

Background

Information seeking, as an important part of the prevention and control of infectious diseases, can lead to positive outcomes by reducing uncertainty and alleviating panic. However, most previous studies have limited their analysis to individual-level psychosocial factors, and little is known about how social-level factors influence individuals' information-seeking intentions.

Methods

The cross-sectional survey was conducted from July 30, 2020 to August 15, 2020 in China. We used a convenience sampling strategy to recruit participants from among the Internet users. The structural equation model was used to identify the incentives associated with coronavirus disease 2019 (COVID-19) risk information-seeking intention.

Results

In this study, the responses of 871 Internet users who reflected a response rate of 85% were analyzed. Information-seeking intention was found to be directed by informational subjective norms (ISNs), perceived information need, risk knowledge, the sense of community (SOC), and negative affective responses, and ISNs were found to be the strongest driving factor. Individuals with a stronger SOC, which was associated with greater pressure and expectations, show negative affective responses. COVID-19 risk knowledge can affect the information-seeking intention of Internet users not only directly but also indirectly through their perceived information need. In addition, more risk knowledge was associated with a lower perceived risk likelihood.

Conclusion

When formulating risk communication strategies, governments and health institutions should take targeted measures to improve the public's SOC and knowledge. This will provide an opportunity to explore the role of individual cognition and environmental risk information in public health.

Positive mental health in Canadian adults who have experienced childhood sexual abuse: exploring the role of social support

PURPOSE

Childhood sexual abuse (CSA) is predictive of poorer mental health, greater psychiatric disorder risk, and lower positive mental health (PMH) during adulthood, outcomes potentially moderated by social support. The current study aimed to explore whether Canadian adults who have experienced CSA differ from those who have not in terms of PMH and social support. Within the CSA sample, it was further investigated whether gender differences exist with respect to PMH and social support, and if particular social support subscales predict PMH.

METHOD

Using data from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), 1,328 adults between 20 and 64 years reporting CSA were profiled and compared in terms of sociodemographic and socioeconomic factors, using an age, sex, and frequency matched sample of non-CSA adults. Social Provisions Scale (SPS), and the Mental Health Continuum - Short Form (MHC-SF) means were subsequently compared between the CSA and non-CSA samples, and Hierarchical regressions were conducted for CSA males and females separately to examine whether SPS subscales predicted PMH after controlling for age and income.

RESULTS

Canadian adults reporting CSA had significantly lower PMH and social support (overall and for particular subscales). For adult CSA females, guidance, social integration, and reassurance of worth predicted higher PMH, while attachment and reassurance of worth predicted higher PMH scores for CSA males.

CONCLUSION

Adults who have experienced CSA are at risk for lower PMH and social support. Gender differences are also evident in social support subtypes that predict PMH which have important clinical implications.

Negative Social Experiences Mediate the Relationship between Sexual Orientation and Mental Health

The lesbian-gay-bisexual (LGB) population experiences a higher rate of psychopathology than the non-LGB population. Minority stress theory (MST) suggests that this pattern of findings is due to the increased negativity that LGB individuals face; however, MST is often employed as a post-hoc explanation for health inequalities as opposed to an a priori approach that explicitly tests this idea and has not been examined in the context of Canadian sexual minorities. Using the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH), we tested the MST on a sample 22,495 Canadians (n = 21,995 non-LGB; n = 500 LGB). Results indicated that respondents' scores on the Negative Social Interactions scale (NSI) partially mediated the relationship between LGB status and both depression and satisfaction with life. The findings suggest that a substantial component of the relationship between sexual orientation and mental health is influenced by deleterious social exchanges.

Association between political group participation and depressive symptoms among older adults: an 11-year longitudinal study in Taiwan

BACKGROUND

Given the speculation that political participation is causing an epidemic of depression, this study examined how participation in political and non-political groups influenced depressive symptoms among older adults in Taiwan.

METHODS

The 11-year follow-up data from the Taiwan Longitudinal Study on Ageing, covering 5334 persons aged 50 years and older, were analysed using random-effects panel logit models.

RESULTS

Engagement in social groups reduced the likelihood of depression (adjusted odds ratio [AOR]: 0.71, 95% confidence interval [CI]: 0.64-0.80). However, there was a greater likelihood of depressive symptoms among older adults who were engaged in political groups when compared with those who were engaged in non-political groups (AOR: 1.87, 95% CI: 1.31-2.65). For older adults who remained politically engaged, participation in a greater number of non-political group types was associated with a lower likelihood of depression (e.g. at 1: AOR: 0.53, 95% CI: 0.30-0.91; at 2+: AOR: 0.35, 95% CI: 0.18-0.67); this numbers-based effect was not prevalent among those who were solely engaged in non-political groups.

CONCLUSIONS

Political group attendance can result in negative mental health outcomes among older adults. Our findings suggest that reducing the prevalence of depression through social participation is conditional to the engagement type.

Examination of Gender Differences in the Influence of Social Support on Psychological Distress in Canadian Adults with Bipolar Disorder

The objectives of this study were to determine whether gender differences exist in how social support, and different types of support, impact psychological distress among Canadian adults with bipolar I and bipolar II disorder (BD), to examine whether females and males with BD differ in their perceived levels of support and distress compared to females and males without BD, and to investigate whether females and males with BD perceive different levels of support and distress. Using a cross-sectional, national datafile, 281 females and 282 males (20-64 years) who reported being diagnosed with BD were investigated using the Social Provisions Scale (SPS) and the Kessler Psychological Distress Scale (K10). It was found that females and males with BD had significantly lower SPS scores and significantly higher K10 scores than females and males without BD, females with BD perceive significantly higher overall support, as well as higher attachment and guidance compared to males with BD, and support in the form of social integration and was associated with decreased psychological distress for both males and females with BD. Furthermore, reassurance of worth was an additional predictor of decreased distress for males, while guidance was an additional predictor of decreased distress for females. Despite the limitations, which include self-reported diagnosis of BD and potential exclusion of those who are not diagnosed but have BD, these findings suggest that different types of social support may serve as protective factors for psychological distress among females and males with BD.

A study of psychological sense of community as a mediator between supportive social systems, school belongingness, and outcome behaviors among urban high school students of color

Psychological sense of community (SOC) has been examined minimally among the youth of color, and as a mediating variable, as well as construct implicated in promoting wellness. Using data from a sample of 401 students of color (M age  = 16.55, standard deviation = 1.31; 54.7% female; 57% Hispanic/Latina[o]) from an underserved northeastern US urban community, we examined the mediating relationship of psychological SOC between social support, participation in youth-based community programs, and outcomes including school belongingness, risk behaviors such as substance use and violent behavior, and psychological symptoms, including depression. Results indicated that access to social supports and youth-based community programs was negatively associated with risk behaviors and experiencing depressive symptoms, through both psychological SOC and school belongingness. Implications include the need for community-based activities for youth that not only foster support but encourage a positive psychological SOC and in-turn offset negative developmental trajectories and risk behaviors.

"A unique little microcosm": Exploring a self-sustaining community project which harnessed social action in a public space

Government policy in England encourages communities to capacity build from within. Community psychology has explored the role of community resilience in this process. But what happens if a community appears to lack formalized resources? This article considers such a community in which a grassroots community center thrives outside the boundaries of formalized community organizations. It aimed to find out how this community mobilized, the benefits for those connected, and how the center survives. A grounded theory 'center as a living organism' was constructed from the accounts of eleven participants. Results indicate how community centers play a role in promoting individual and community level well-being and preventing distress. The importance of learning from progressive community initiatives and more partnership working between National Health Service, statutory, voluntary, and community groups is indicated. Effective engagement with and across communities to promote resilience and well-being is also a theme of the responses to recent events in England, such as the terrorist attacks and the Grenfell Tower fire.

The influence of social support on psychological distress in Canadian adults with bipolar disorder

INTRODUCTION

Individuals with bipolar I disorder (BD-I) and bipolar II disorder (BD-II) are at higher risk for experiencing high levels of psychological distress and low levels of social support.

OBJECTIVES

The primary objectives of this study were to examine perceived social support and psychological distress among Canadian adults with self-reported BD-I or BD-II as diagnosed by a health professional and explore the relationship between types of social support and psychological distress within this sample.

METHODS

Using a cross-sectional, national datafile, 563 Canadian male and female adults (20-64 years) who reported being diagnosed with BD-I or BD-II were investigated using the Social Provisions Scale (SPS), and the Kessler Psychological Distress Scale (K10).

RESULTS

It was observed that while the BD-I or BD-II sample had significantly lower SPS scores and significantly higher K10 scores than the overall Canadian sample, age and support in the form of reassurance of worth and social integration were associated with decreased psychological distress. Further, a diagnosis of BD-I and BD-II was found to moderate the effect of social support on psychological distress.

CONCLUSIONS

Despite the limitations, which include self-reported diagnosis of BD-I and BD-II and potential exclusion of those who are not diagnosed but have BD-I or BD-II, these findings suggest that reassurance of worth and social integration may act as protective factors for psychological distress among individuals with BD-I or BD-II.

Negative trust and depression among female sex workers in Western China: The mediating role of thwarted belongingness

Female sex workers are at high risk for depression in China but they are understudied and underserved. Based on cognitive models of depression, dysfunctional beliefs about oneself and others may act as vulnerability factors for depression. However, the association between negative trust and depression is still under debate. The present study aimed to test the hypothesis that negative trust positively relates to depression through thwarted belongingness among female sex workers. Four hundred and fifty-seven participants completed measures of negative trust, thwarted belongingness, and depression. Stepwise multiple linear regression analyses showed that both negative trust and thwarted belongingness significantly positively predicted depression, and thwarted belongingness was positively predicted by negative trust. The results from the mediation analysis suggest that thwarted belongingness might be an underlying mechanism linking negative trust and depression. Psychological interventions could focus on helping female sex workers form and strengthen meaningful social connectedness (the behavioral/observable indicators of the constructs of thwarted belongingness).

#WhyWeTweetMH: Understanding Why People Use Twitter to Discuss Mental Health Problems

Background

Use of the social media website Twitter is highly prevalent and has led to a plethora of Web-based social and health-related data available for use by researchers. As such, researchers are increasingly using data from social media to retrieve and analyze mental health-related content. However, there is limited evidence regarding why people use this emerging platform to discuss mental health problems in the first place.

Objectives

The aim of this study was to explore the reasons why individuals discuss mental health on the social media website Twitter. The study was the first of its kind to implement a study-specific hashtag for research; therefore, we also examined how feasible it was to circulate and analyze a study-specific hashtag for mental health research.

Methods

Text mining methods using the Twitter Streaming Application Programming Interface (API) and Twitter Search API were used to collect and organize tweets from the hashtag #WhyWeTweetMH, circulated between September 2015 and November 2015. Tweets were analyzed thematically to understand the key reasons for discussing mental health using the Twitter platform.

Results

Four overarching themes were derived from the 132 tweets collected: (1) sense of community; (2) raising awareness and combatting stigma; (3) safe space for expression; and (4) coping and empowerment. In addition, 11 associated subthemes were also identified.

Conclusions

The themes derived from the content of the tweets highlight the perceived therapeutic benefits of Twitter through the provision of support and information and the potential for self-management strategies. The ability to use Twitter to combat stigma and raise awareness of mental health problems indicates the societal benefits that can be facilitated via the platform. The number of tweets and themes identified demonstrates the feasibility of implementing study-specific hashtags to explore research questions in the field of mental health and can be used as a basis for other health-related research.

Unbelievable?! Theistic/Epistemological Viewpoint Affects Religion-Health Relationship

Research suggests that Religion/Spirituality promotes a variety of positive health outcomes. However, despite reporting lower levels of Religion/Spirituality, non-believers report comparable levels of health to believers. The current study tested the hypothesis that Religion/Spirituality does not have a uniform effect on health for all persons, and tested theological/epistemological categories as moderators. Using the 2012 and 2014 General Social Survey (N = 2670), the relationship between Religion/Spirituality and happiness and self-rated health was investigated. Results indicated that Gnostic Theists experienced Religion/Spirituality more positively than their peers did; Agnostic Theists experienced Religion/Spirituality less positively than their peers did; and Negative Atheists experienced Religion/Spirituality less positively than their peers did. These findings suggested that Religion/Spirituality is not associated with salutary effects for all persons, and that whether a person believes in god(s) and how confident he/she was in god(s)' existence, influenced his/her experience with Religion/Spirituality.

Depleted Resources and Chronic Stress

There is a well-established relationship between number and severity of stressful life events and the onset of depression. Cognitive-behavioral therapy (CBT) for depression should include relevant evaluation of chronic stressors and skill building related to garnering available resources. This clinical case study illustrates the use of a CBT approach to treating depression in an individual with a complicated history of life stressors. An adult woman with recurrent major depressive disorder sought treatment at a university-based psychology training clinic and received outpatient individual psychotherapy on a weekly basis. Therapeutic progress was evaluated through self-reported depression and anxiety symptom change, therapist observation of affect, and client and therapist assessment of progress toward therapeutic goals. This case highlights several key factors to consider when providing outpatient psychotherapy to address symptoms of depression in adults with severely depleted resources, particularly bolstering the utilization of social support.

Social anxiety disorder in the Canadian population: exploring gender differences in sociodemographic profile

The present study examined the prevalence and sociodemographic profile of Canadians with social anxiety disorder using data from the Canadian Community Health Survey Cycle 1.2 (N = 36,984). Social anxiety disorder was assessed using the World Mental Health Composite International Diagnostic Interview and sociodemographic variables were explored by gender. Results suggested significant gender differences for prevalence, comorbid depression, marital status, living arrangements, employment status in the past 12 months, and self-reported mental health status. These observations suggest that individuals with social anxiety disorder experience life disruption, and that of all socially anxious respondents, females may be experiencing more distress than males.