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PubMed1994

Service providers in the social networks of clients with severe mental illness.

The social networks of 27 severely mentally ill (SMI) clients of two community mental health centers were compared with those of 19 clients who had less severe disorders. The networks of the SMI clients were smaller and less reciprocal and contained fewer family members. SMI clients' networks were also more likely to include social service providers, such as group home staff and caseworkers. These social service providers gave direct advice and medical, food, and financial assistance in addition to emotional support, but the relationships were nonreciprocal. Clients with the fewest indigenous supports had the most social service links. These findings suggest that mental health services for SMI persons may provide substitute social supports that serve a broader function than more traditional emotional therapy.

Adult↗
PubMed1991

Social networks and recovery: one year after inpatient treatment.

In an effort to understand the effect of social networks on outcome for treatment of alcoholism, a 1-year follow-up prospective study of 156 inpatients was undertaken. Treatment outcome was associated with diverse aspects of the social network: whether individuals were family, friends, or co-workers; the type of relationship--whether or not drinking together was part of social interaction; and the presence of social support, both perceived support and support through participation in treatment. Hierarchical path analysis using Lisrel 6 was used to analyze the data. The active support of co-workers not regularly drinking with the patient and the perceived support of co-workers without respect to their drinking were influential in recovery, exerting positive and negative effects, respectively. The indirect effect of other variables indicates that nondrinking and drinking family and friend relationships also exert positive and negative effects, respectively. The authors suggest that a major factor in recovery is the ability to elicit and receive support. Improving this ability may be a fruitful objective in treatment.

Adolescent↗
PubMed2004

Substance use, social networks, and the geography of urban adolescents.

This article demonstrates a research strategy and prevention methodology for substance using urban youth that incorporates individual, social, and geographical parameters to systematically understand the ecology of risk and protection for urban youth. The primary goal of this study was to describe and analyze substance using and nonusing urban adolescents' social networks; risky and protective settings where they socialize; and the relationship to health outcomes such as substance use, depression, and stress. Geographic Information Systems (GIS) derived spatial relationships and analyses between the specific locations where the teens are active, their subjective ratings of these locations, and objective environmental risk data. These social network and GIS data were merged to form a detailed description and analysis of the social ecology of urban adolescent substance use. A case study was constructed to illustrate the methodology of creating a three-dimentional ecological profile that helps explain these relationships and provides preventive applications. Linear distances were computed between the homes of the users and the risky and safe places that they identified. On average, the distance between users' homes and their identified safe places was three times the distance between their homes and their identified risky places. This study provides support for understanding urban adolescent substance use through the detailed and multiple dimensional analysis of teens' social ecologies.

Adolescent↗
PubMed1991

Effects of sheltered care environments and resident characteristics on the development of social networks.

Two hundred and thirty-four members of a 1973 sample of sheltered care residents, three-fourths of whom had schizophrenic disorders, were followed up between 1983 and 1985 to examine the role of supportive and of transitional, high-expectation sheltered care environments in the development of residents' social networks. The influences of revolving-door treatment experiences, psychopathology, and institutionalization were taken into account. The results showed that supportive rather than transitional, high-expectation environments contributed to the development of emotionally and instrumentally supportive social networks. Higher levels of psychopathology and a history of institutionalization resulted in the absence of certain support relationships. Surprisingly, revolving-door treatment experiences were related to positive support and social network outcomes.

Adult↗
PubMedDate not supplied

Psychogeriatric organization in the medico-social network: the experience of the canton of Vaud, Switzerland.

In Switzerland (7 million inhabitants), the organization of health care is in the hand of the cantons and not of the Confederation. The canton of Vaud (600,000 inhabitants), in the south-west part of the country, counts 4 psychiatric sectors, each with a psychogeriatric service. Otherwise the canton has 146 long-stay facilities with a total of 6,000 beds, of which 600 are for psychogeriatric cases. Home care is in charge of a network of 38 medico-social centres with multidisciplinary teams including psychiatric nurses. Several nursing homes, some specialized in psychogeriatrics, are equipped, besides long-stay beds, by units for temporary care, for medico-social emergencies and for medico-social observations. Moreover, in Lausanne (250,000 inhabitants) an 'Orientation Office of Medico-Social Emergencies', with psychiatric nurses, assumes emergencies at home and by-passes hospitalizations of medico-social cases in the General Hospital, by the resource of medico-social emergency beds in the nursing homes. The medico-social network thus designed in this way is profoundly permeated with the reality of psychogeriatrics.

Aged↗
PubMed1998

Social network factors associated with perceived quality of life. The San Luis Valley Health and Aging Study.

Demographic and social network factors associations with perceived quality of life (PQOL) were examined in a sample of rural Hispanic and non-Hispanic White (NHW) elderly. A 20-item PQOL scale measured participants' satisfaction with multiple facets of their lives. Age, gender, marital status, and living alone were not associated with this outcome. Hispanic persons with higher incomes had consistently higher ratings of quality of life compared to NHWs. More education was associated with a higher PQOL rating only among NHWs. More close friends and relatives, visiting in homes, and participation in outside activities were all independently related to PQOL. Interaction tests showed that the impact of social networks was stronger in NHWs. These findings suggest that network size and contact are important social factors that can improve quality of life for both ethnic groups. However, differences may need to be examined when judging the magnitude of these associations and when planning interventions.

Aged↗
PubMedDate not supplied

Social networks and mortality in an inner-city elderly population.

The authors address some of the methodological problems found in earlier investigations of the relationship between social networks and mortality. Of particular concern was the use of rudimentary measures of social interaction in previous work. Utilizing nineteen social network variables, the authors examined 155 elderly residents of midtown Manhattan single-room occupancy hotels. On three-year follow-up, twenty-eight persons had died. Discriminant function analysis indicated that ten of nineteen network variables were relatively strong discriminators between survivors and non-survivors (i.e., standardized coefficient of .20 or greater). The network variables cut across all categories of social interaction, thereby revealing why, despite the few network variables used in previous studies, nearly all had been significant.

Aged↗
PubMed2003

An experimental study of search in global social networks.

We report on a global social-search experiment in which more than 60,000 e-mail users attempted to reach one of 18 target persons in 13 countries by forwarding messages to acquaintances. We find that successful social search is conducted primarily through intermediate to weak strength ties, does not require highly connected "hubs" to succeed, and, in contrast to unsuccessful social search, disproportionately relies on professional relationships. By accounting for the attrition of message chains, we estimate that social searches can reach their targets in a median of five to seven steps, depending on the separation of source and target, although small variations in chain lengths and participation rates generate large differences in target reachability. We conclude that although global social networks are, in principle, searchable, actual success depends sensitively on individual incentives.

Electronic Mail↗
PubMed2000

Social network size of female patients with rheumatoid arthritis compared to healthy controls.

UNLABELLED: To estimate how rheumatoid arthritis (RA), the disease duration, and level of physical disability, influence the total size of patients' social network and the size of different subsets. Two hundred sixty four female patients (mean age 57 yrs) with RA of more than 6 yrs duration (mean 20 yrs) were compared to 61 healthy controls matched for sex, age, and residential area. Network size was measured by Social Network Delineation Questionnaire (SNDQ), physical disability by Health Assessment Questionnaire (HAQ). RA patients had a significantly smaller total network compared to the healthy controls (RA: 15.8 persons; CONTROLS: 18.1), mostly due to a significant difference in the subset of important others in favour of the controls (RA: 1.1; CONTROLS: 2.3). There were no significant differences regarding the network size of family, friends, and neighbours. The same results remained after statistical control for sociodemographic variables. Neither disease duration nor physical disability had any significant association with network size. The interaction analysis did, however, show that non-working patients with long disease duration (> 15 yrs) had fewer important others than occupationally active patients. Furthermore, a high degree of physical disability was related to a smaller number of friends for patients > 57 yrs than for equally disabled patients below this age. Most patients with RA seem to maintain contact with the family network-members, despite the challenges connected with chronic disease.

Adult↗
PubMedDate not supplied

Social network and coronary artery calcification in asymptomatic individuals.

BACKGROUND: Psychosocial factors are associated with the development of coronary artery disease. However, studies examining psychosocial factors as risk indicators for coronary artery calcification (CAC) have been inconclusive. METHODS: Seven hundred eighty-three participants (mean age 57.4 +/- 9.3 years, 47% female) underwent CAC imaging using electron beam tomography. Psychosocial measures included social network (number of people in the household, marital status), socioeconomic status (education, income, and work status), history of depression, and current depressive symptoms as assessed with the Center for Epidemiologic Studies Depression (CES-D) scale. Assessments were also made for lipid profile, blood glucose, blood pressure, and health behaviors (smoking status, exercise, and diet). RESULTS: Calcification was present in 351 (44.8%) participants (CAC score range 0-3022; mean 111.5 +/- 307.2). Indicators of social isolation (being single or widowed) were independently associated with elevated risk for the presence of CAC, even after adjustment for age, sex, systolic blood pressure, blood glucose, and low-density lipoprotein (adjusted odds ratios 1.80, 95% confidence interval [CI] = 1.05-3.10, and 2.48, 95% CI = 1.02-6.03, respectively). By contrast, health behaviors, socioeconomic status, and depressive symptoms were not related to CAC. CONCLUSIONS: Social network indices such as being single or widowed are associated with CAC, independent of age and coronary risk factors. Because coronary calcification has been identified as a potential marker of early atherosclerosis, these findings may partially explain the predictive value of limited social networks for future adverse cardiovascular health outcomes.

Aged↗
PubMed2001

[A review of epidemiological studies on the relationship of social networks and support to depressive symptoms in the elderly].

This paper reviews evidence concerning the relationship of social support and networks to psychological well-being in elderly people. Although few studies have used comparative concepts and featured measurements of social networks and social support, the overall findings are that depressive symptoms in elderly people are associated with (a) smaller size of social networks which are supportive, (b) lower emotional support which is anticipated or received, (c) lower instrumental support which is anticipated, and (d) not providing support to others, and that depressive symptoms are greater when the amount of received instrumental support is larger. There is evidence consistent with both direct effects of social networks and support on reducing depressive symptoms, and buffering effects to protect persons from adverse effects of stressful life events. In addition, physical health status, activities of daily living, income, and marital status are associated with depression among the elderly. A well-conducted longitudinal study is essential for research in this area in Japan.

Aged↗
PubMed1991

The COSTAR programme. 1: Improving social networks of the long-term mentally ill.

The present study examined the socio-demographic, clinical, cognitive, social behaviour and social network characteristics of the 97 patients in contact with the COSTAR programme--a mobile treatment and case management service for the long-term mentally ill in inner-city Baltimore. Compared with shorter-contact patients, those in contact for more than one year showed no change in symptoms, or in cognitive or global function. They did manifest improved social function, especially for slowness, personal hygiene and posturing. The long-contact group showed improvements in the quality and quantity of their social networks. Our results suggest that a home-based treatment system can help patients to reverse a vicious cycle of social isolation and to establish supportive social contacts.

Activities of Daily Living↗
PubMed2005

[Social support offered by members of the social network: the point of view of mothers in situation of vulnerability].

The present study focuses on informal social networks and the people who give parental support to at-risk mothers (i.e., mothers who display at least two of the following risk factors : low SES, low education, and under 21 years at the birth of their first child). A sample of 49 such mothers, who had children between the ages of 2 and 6 years, participated in semi structured interviews. The group was then matched with a group of low risk mothers (n = 43). Results present mothers' perspectives on the people in their social network they see as being most helpful or most stressful, as far as parenting is concerned. They also describe the roles played by key members of their immediate environment (maternal grandmothers, spouse or ex-spouse). Practical guidelines towards a network-oriented approach in parental support are outlined.

Adult↗
PubMed2005

Combating loneliness among persons with severe mental illness: social network interventions' characteristics, effectiveness, and applicability.

More than half of people with severe mental illness are lonely, the subjective state associated with social isolation and lack of desired relationships. Their loneliness is related to impaired ability to make and keep friends, lack of opportunities to participate in social activities, and stigma associated with mental illness that creates barriers between them and their communities. Treatment for people with severe mental illness often fails to include social network interventions that have the potential to decrease loneliness. Knowledge of social network interventions-their characteristics, effectiveness, and applicability for specific patients-can guide nurses' use of these treatment modalities.

Attitude to Health↗
PubMed2006

Of pride and prejudice: the role of sociology and social networks in integrating the health sciences.

Calls have been issued for understanding the "contexts" or "environment" shaping the causes and consequences of health and health care. Existing efforts raise concerns about how a panorama of influences can be considered simultaneously. Sociology's view of contexts as social network structures that shape and are shaped in social interaction offers one key to resolving this dilemma. Because social networks have become central in the social, natural, and physical sciences, this perspective provides a common platform for bringing in sociology's rich theoretical and methodological insights. Yet, to do this well, three conditions must shape our response. First, all levels relevant to health and health care must be considered, separated out, and linked by network mechanisms. The genetic-biological level, perhaps the most foreign level to sociologists, represents the greatest need and best prospect for advancing a sociologically based solution. Second, room must be made to tailor models to populations, whether defined socially or medically. Third, sociologists must find a voice within "big science " to address problems from social construction to social causation that contribute to basic social processes as well as health. I trace developments in the Network-Episode Model as one theoretical starting point.

Humans↗
PubMed1998

Adolescent depression. Epidemiology, nosology, life stress and social network. Minireview based on a doctoral thesis.

The study engaged a total population of 16-17-year-old urban high-school students and 2300 (93%) were screened for depression and previous suicide attempts. Adolescents with high depression scores in self-evaluation (12.3%) or reporting previous suicide attempts (2.4%) were diagnostically interviewed together with one control for each, matched for gender and educational program. After the interview self-ratings were completed regarding social network, family climate, and life events. Major depression was prevalent during the last year in 5.8% and during life time in 11.4%, 4 girls for every boy. A depression with remaining symptoms for a year or more was the most common type. Dysthymia without major depressive episodes was diagnosed in 1.1%, two girls for every boy. Short hypomanic episodes had been experienced by 13.2% of those with major depressive disorder. Anxiety disorder was comorbid to depression in one half and conduct disorder in one forth of the depressed adolescents. Alcohol was abused by 6.5% and used regularly by another 12%. Other drugs were used by 6.5% of depressed adolescents and not at all by controls. The depressed used tobacco twice as frequently as non-depressed. Social network and family climate were compared within the originally matched pairs. Adolescents with long-lasting depressions had a smaller and unsatisfying social network. They also had experienced many stressful life events related to family adversities, while those with shorter depressive episodes had stress related to the peer group. Depressed adolescents with comorbid conduct disorder reported insufficient support from the close network and a more negative family climate.

Adolescent↗
PubMed1990

Social networks and health: impact on returning home after entry into residential care homes.

This research extends the study of social network analysis and labeling theories into the context of residential care homes (RCHs). Findings suggest that: (1) when members of intense social networks decide to move elderly persons into RCHs, placement is truly needed and (2) although the likelihood of returning home from RCHs is affected by sociocultural characteristics, the functional and cognitive status of the resident are of primary importance.

Aged↗
PubMed1994

Social network characteristics in fibromyalgia or rheumatoid arthritis.

PURPOSE: To describe trends in the personal social network characteristics of the fibromyalgia patients compared with the network of patients with another chronic disorder such as rheumatoid arthritis (RA). METHODS: A structured interview was applied to 10 fibromyalgia patients and 10 matched RA patients. RESULTS: The networks of the 10 fibromyalgia and 10 RA patients were comparable in most respects, namely: the small number of intimate friends, the reliance for support on the spouse and the physician, and the relative lack of new social contacts. Furthermore, the fibromyalgia networks were closed networks within a small geographic area. These networks lacked initiative to establish and maintain relations, and can hardly fulfill the patients' psychosocial needs. CONCLUSION: Based on small numbers, the study provides some evidence that social networks of patients with fibromyalgia are more restricted than those of RA patients. Further studies should include larger numbers of patients to clarify cause and effect relationships and to suggest new directions in the treatment of chronic disorders such as fibromyalgia.

Adolescent↗