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The social networks of older schizophrenia patients. Clinical Research Center on Late Life Psychosis Research Group.

There is a paucity of research that examines the role of family members and friends in the lives of older schizophrenia patients. This study compared 66 middle-aged and elderly outpatients with 31 normal comparison subjects. Five dimensions of social network were assessed: (a) family composition, geographic proximity, and frequency of contact; (b) instrumental support; (c) emotional support and interpersonal difficulties; (d) role of friends; and (e) use of formal service providers as sources of support and assistance. As compared with normal subjects, the schizophrenia patients were less likely to be married, less likely to have children, more likely to live alone, and had fewer friendships. The patients were, however, similar to comparison subjects on the following family-relationship variables: frequency of contact, instrumental support received, presence of a family confidant, and extent of interpersonal difficulties. These findings do not support the stereotype of older schizophrenia patients as being estranged from family members. The need for developing interventions that use key family members to interface with service providers and to monitor treatment compliance and continuity of care is discussed.

Age Factors↗

Mastery in patients with schizophrenia living in the community: relationship to sociodemographic and clinical characteristics, needs for care and support, and social network.

In line with user involvement and empowerment in individuals who suffer from a severe mental illness, the sense of mastery is important. Few studies have investigated factors that contribute to mastery in individuals with schizophrenia. The aims of the present 18-month follow-up study were to investigate associations between mastery and clinical and sociodemographic factors, needs for care and support and social network, and to investigate whether changes in mastery were related to changes with regard to these aspects in a group of patients (n = 120) with schizophrenia living in the community. Structural interviews were performed at baseline and after 18 months. Pearlin's mastery scale, the Camberwell Assessment of Needs (CAN), the Interview Schedule for Social Interaction (ISSI), and the Brief Psychiatric Rating Scale (BPRS) were used on both interview occasions. A stepwise regression analysis showed a negative relationship between psychopathology, especially affective and negative symptoms, and mastery. Stronger mastery was associated with younger age and less severe basic needs. In total psychopathology, age and basic needs explained 50.7% of the variance in mastery. Changes in mastery were positively correlated to changes in access to social contact but negatively correlated to changes in affective symptoms. In order to target mastery in individuals with schizophrenia, the community-based nursing services need to develop, implement, and evaluate interventions that are effective for psychiatric symptoms, social skills performance, and needs for care and support in areas of living, nutrition, and daytime activities.

Adaptation, Psychological↗

[Dynamic models and social networks: a review and reflections on their contribution to understanding the HIV epidemic].

Due to certain specificities in the HIV epidemic, its spread has escaped the random transmission pattern of other infectious diseases. Observation of the epidemic has shown that individual behavior - relational patterns among individuals - plays a crucial role in HIV transmission and that strategies to prevent the epidemic's spread should take this factor into account in order to foster efficient allocation of existing resources. Mathematical and statistical models applying the behavioral approach to the epidemic have estimated interactions between groups whose characteristics and behaviors varied. However, such models have been more "post-dictive" than predictive, due to the inadequate representation of social structures in populations through which infectious agents spread. The social network methodology thus came to be applied to the approach to the HIV epidemic. This article discusses alternatives for the application of this methodology to the Brazilian epidemic, considering that sociometric risk networks structure the flow of infectious agents in communities, creating unique opportunities to interrupt their spread.

Acquired Immunodeficiency Syndrome↗

Disclosure patterns within social networks of gay men and lesbians.

Gay men and lesbians must make decisions about disclosure of their sexual orientation. Past research has focused on an individual's overall level of disclosure or on disclosure to a specific subset of individuals. This study used a new measure, the Disclosure Grid, to assess the disclosure patterns of 89 gay men and 55 lesbians across their entire social network. In addition to assessing disclosure to each network member, the Grid also assessed perceived relationship quality prior to disclosure and currently. Finally, the Grid assessed perceptions of each network member's initial and current acceptance of the gay or lesbian person's sexual orientation. Data provide a rich portrait of disclosure patterns among a heterogeneous, urban sample of lesbians and gay men. Analyses also found support for three hypotheses about disclosure, relationship quality, and acceptance. For example, it was found that participants have better relationships with individuals they have directly told about their sexual orientation than with people who found out in an indirect manner.

Adolescent↗

A simple rule for the evolution of cooperation on graphs and social networks.

A fundamental aspect of all biological systems is cooperation. Cooperative interactions are required for many levels of biological organization ranging from single cells to groups of animals. Human society is based to a large extent on mechanisms that promote cooperation. It is well known that in unstructured populations, natural selection favours defectors over cooperators. There is much current interest, however, in studying evolutionary games in structured populations and on graphs. These efforts recognize the fact that who-meets-whom is not random, but determined by spatial relationships or social networks. Here we describe a surprisingly simple rule that is a good approximation for all graphs that we have analysed, including cycles, spatial lattices, random regular graphs, random graphs and scale-free networks: natural selection favours cooperation, if the benefit of the altruistic act, b, divided by the cost, c, exceeds the average number of neighbours, k, which means b/c > k. In this case, cooperation can evolve as a consequence of 'social viscosity' even in the absence of reputation effects or strategic complexity.

Altruism↗

[The relation between life style, socioeconomic factors, social networks and suboptimal self-assessed health].

INTRODUCTION: The aim of the present study was to assess the relation between these life-style factors and suboptimal self-reported health. METHODS: A cross-sectional study was carried out on a random sample of 12,040 men and women from Copenhagen, who had answered a questionnaire regarding smoking, alcohol intake, physical activity, socio-economic status, social network, and self-perceived health. RESULTS: Smoking, high alcohol intake, and physical inactivity are strongly associated with a suboptimal self-reported health. DISCUSSION: The assumption of a correlation between a high quality of life and a shorter life cannot be confirmed by this study.

Adult↗

Job demands, job decision latitude, job support, and social network factors as predictors of mortality in a Swedish pulp and paper company.

Three hundred and ninety one male employees aged 35-65 in a Swedish pulp and paper company were followed up for 22 years; 151 deaths were recorded by 31 December 1983. On the basis of data from 1961, indices for job decision latitude, job support, and other work related psychosocial factors were constructed as were five indices for non-work related social network factors. All indices were checked by life table analysis in respect of mortality. Job decision latitude and a combined index for job decision latitude and job support showed significant associations with mortality. These two indices were investigated by multivariate analysis with scale for evaluation of neuroticism and known somatic risk factors such as smoking, cholesterol, and systolic and diastolic blood pressure. Age, educational level, occupational status, physically heavy work, and general health state were also included in the multivariate analysis. Age, systolic blood pressure, the combined index for job decision latitude and job support, smoking, and neuroticism were shown to be independent predictors of mortality.

Actuarial Analysis↗

Does help help? The adaptive consequences of obtaining help from professionals and social networks.

This study reports on a longitudinal analysis of changes in adaptation associated with seeking help on a representative sample of Chicago area adults who had experienced one of three transitions or four crises during the interval between 1972 and follow-up 1976--77 interviews. For each event, respondents are classified into three groups according to their help-seeking behavior: those who went to professionals, those who went only to their social networks, and those who had the event but sought no help. Nine measures of adaptation are used: symptoms of anxiety and depression and strains and stresses in four role areas. Statistical controls equate the groups on demographic characteristics, perceived stress, personal resources, access to help, and elapsed time since the event. There are no consistent statistical significant differences among the groups. No evidence is found that help-seeking has positive adaptive consequences. The findings are not likely to result from an inadequate sample, outcome measures, or statistical controls, but could result from insufficient information on the kind, quality, and duration of the help provided.

Adaptation, Psychological↗

Health and social networks as predictors of survival in old age.

A random sample of non-institionalised Swedish elderly (n = 1,062; aged 67 +) were interviewed in 1954. All of them are now deceased; their interview data have been completed with dates of death and causes of death. A measure of survival capacity has been used, based on the endured total mortality risk from examination until death, according to life tables from Statistics Sweden. Survival analyses were performed by gender on the whole sample and on a number of sub-samples defined by age, health-status, social class, and marital status at examination. Physical health status and activity patterns had the overall most significant effects on subsequent longevity. Among the youngest elderly mental health was, however, even more important as a predictor of survival than was physical health. The impact of most other factors like social networks, mobility, and religiosity was of less magnitude, but their importance varied among sub-samples. Most of the variation in survival, however, remains unexplained.

Activities of Daily Living↗

Adherence to zidovudine for the prevention of perinatal transmission in HIV-infected pregnant women: the impact of social network factors, side effects, and perceived treatment efficacy.

Adherence to zidovudine (ZDV) prophylaxis among 78 pregnant HIV-infected women was measured with 2 physiologic markers. Long-term adherence was measured with blood assays for macrocytosis, a clinical indicator of ZDV use; 53 women (67.9%) were adherent. Short-term adherence was measured with urine assays for ZDV; 48 women (61.5%) were adherent. Comparison of urine assay and interview data indicated that 29% had not taken the last dose that they reported. Participation in HIV support groups and disclosure to the participant's mother were associated with better adherence. These social network factors may enable HIV-infected pregnant women to cope more effectively with the multiple stressors they face and facilitate prenatal care.

Adult↗

A social network analysis of communication about hereditary nonpolyposis colorectal cancer genetic testing and family functioning.

Hereditary cancers are relational diseases. A primary focus of research in the past has been the biological relations that exist within the families and how genes are passed along family lines. However, hereditary cancers are relational in a psychosocial sense, as well. They can impact communication relationships within a family, as well as support relationships among family members. Furthermore, the familial culture can affect an individual's participation in genetic counseling and testing endeavors. Our aims are (a) to describe the composition of familial networks, (b) to characterize the patterns of family functioning within families, (c) to analyze how these patterns relate to communications about genetic counseling and testing among family members, and (d) to identify influential family members. Specifically, we asked how the relationship between mutation status, kinship ties, and family functioning constructs, e.g., communication, cohesion, affective involvement, leadership, and conflict, was associated with discussions about genetic counseling and testing. We used social network analysis and random graph techniques to examine 783 dyadic relationships in 36 members of 5 hereditary nonpolyposis colorectal cancer (HNPCC) families interviewed from 1999-2000. Results suggest that in these five HNPCC families, two family members are more likely to discuss genetic counseling and testing if either one carries the mutation, if either one is a spouse or a first-degree relative of the other, or if the relationship is defined by positive cohesion, leadership, or lack of conflict. Furthermore, the family functioning patterns suggest that mothers tend to be the most influential persons in the family network. Results of this study suggest encouraging family members who act in the mother role to take a "team approach" with the family proband when discussing HNPCC risks and management with family members.

Adult↗

Reciprocity in marital and social networks: illustration with Indian data.

Three measures of reciprocity, denoted s2, s3, and s4, that are applicable to both simple and weighted networks are considered here. By reciprocity I mean symmetry or mutuality of ties between different vertices of the network. These measures have simple formulas except in some extreme situations and can be used for most networks. Among the three measures, s2 is generally preferred, although the choice in any situation depends on the validity of the assumptions underlying its derivation and its discriminating power. I illustrate how reciprocity in the network of marital exchanges between different surnames and settlements can reveal something about the structure of a population. Reciprocity is higher if the endogamous group is close-knit, is well settled in a smaller geographic area, and has a low surname diversity index. Thus reciprocity is high in the Vadde, somewhat high in the Pattusali, and low in the Yanadi. Although s2, s3, and s4 measure reciprocity in a network as a whole, the local reciprocity index can be used to see how reciprocally a particular vertex is tied to others and can help in the study of the direction of the exchanges. The low local reciprocity indexes of the neighborhood settlements of the Yanadi in some regions indicate that the settlements are involved in one-way marital exchanges with other settlements. The study of reciprocity can be relevant in other contexts also. High reciprocity in a well-settled population was also observed in the social networks of 21 villages with respect to the "help" relation. It was found that reciprocity is highly negatively correlated with the percentage of migrants in the village but does not show high positive or negative correlation with other demographic, socioeconomic, and location characteristics of the villages.

Female↗

Socioeconomic differences in health indices, social networks and mortality among Swedish men. A study of men born in 1933.

BACKGROUND: In previous survey we found large socioeconomic differences in mortality among urban Swedish men which remained unexplained after controlling for smoking and standard coronary risk factors. The present analysis was undertaken in order to investigate a broader set of possible explanatory factors in another cohort of Swedish men. STUDY POPULATION AND METHODS: Occupation was coded into five occupational classes for 717 of 776 participant men from a random population sample of 1016 men who were born in 1933. All were living in Göteborg and were 50 years old at the baseline examination. After 12 years' follow-up, 68 of the 717 men had died (9.5%). RESULTS: Low occupational class was associated with a higher prevalence of smoking at baseline, but no association was found with systolic blood pressure, body mass index, waist to hip ratio, serum triglycerides or serum cholesterol. Subjects from higher socioeconomic strata were taller, had higher maximum peak respiratory flow, lower plasma fibrinogen and lower body temperature. Low occupational class was associated with low social integration, low home activity levels, low levels of activity outside home and low social activity levels (p = 0.001 for all) and with low emotional support (p = 0.018). There were also associations between low occupational class and poor self-perceived health, as well as with several cardiovascular symptoms. During 12 years' follow-up, there was a graded and inverse relationship between occupational class and mortality from all causes. The highest mortality was found among the men who could not be classified (23 per 1,000 person years) Of the men in the lowest occupational class, 12 per 1,000 died, compared to 3 per 1,000 in the highest class (relative risk 3.7 (1.4-9.8)). After controlling for smoking, the relative risk decreased to 3.2 (1.2-8.6) and after further adjustment for emotional support, self-perceived health, activity level at home, and peak expiratory flow, the relative risk was still twofold but not significantly so (RR 2.1 (0.8-5.8)). CONCLUSION: We were able to confirm earlier results as to the wide mortality differentials in urban middle-aged men in Sweden. There were also large differences in several other factors, including constitutional factors, health variables, lifestyle and social support indices, which explained important parts of the social mortality gradient, the most prominent being smoking, respiratory function, social network factors and subjective health.

Aged↗

Social insect networks.

Social insect colonies have many of the properties of adaptive networks. The simple rules governing how local interactions among individuals translate into group behaviors are found across social groups, giving social insects the potential to have a profound impact on our understanding of the interplay between network dynamics and social evolution.

Animals↗

Modelling the spread of HIV in social networks of injecting drug users.

OBJECTIVE: To explore the risk of a future rise of HIV prevalence in populations of injecting drug users (IDU) with low HIV prevalence but continuing risk behaviour, and to study the potential influence of prevention measures on HIV incidence. METHODS: A stochastic simulation model was used to describe a network of long-term buddy relationships in a population of IDU. HIV transmission took place when borrowing injecting equipment from an infected buddy or stranger. The probability of transmission depended on the duration of infection. Individuals remained in the population on average for 10 years. Two surveys amongst IDU in The Netherlands containing information about risk behaviour were used to estimate model parameters. We investigated the effect of different prevention strategies. RESULTS: Below a threshold sharing frequency the epidemic never takes off; above the threshold there is a large stochastic variation in prevalence. After reduction of risk behaviour, HIV prevalence decreases very slowly. Reducing sharing with strangers is more effective than reducing the overall sharing frequency. Prevention focused on new IDU greatly reduces HIV incidence. Reduction of sharing frequency in HIV-positive IDU has no significant influence on HIV incidence at HIV testing rates of 10 and 50% per year, if infectivity is highest during primary infection. CONCLUSIONS: A stabilization of HIV prevalence does not exclude the possibility of a future rise. Predictions about the future course of an epidemic are inherently uncertain. The effect of prevention programmes on HIV prevalence only becomes visible on a long time-scale. Social networks of IDU play an important role in transmission dynamics and success of prevention.

HIV Infections↗

Social networks, travel and talk.

This paper considers the role that physical, corporeal travel plays in social life. There is a large and increasing scale of such travel. This increase has occurred simultaneously with the proliferation of communication devices that in some ways substitute for physical travel. I hypothesize that the bases of such travel are new ways in which social life is 'networked'. Such increasingly extensive networks, hugely extended through the informational revolution, depend for their functioning upon intermittent occasioned meetings. These moments of physical co-presence and face-to-face conversation, are crucial to patterns of social life that occur 'at-a-distance', whether for business, leisure, family life, politics, pleasure or friendship. So life is networked but it also involves specific co-present encounters within specific times and places. 'Meetingness', and thus different forms and modes of travel, are central to much social life, a life involving strange combinations of increasing distance and intermittent co-presence. The paper seeks to examine the place of travel within the emergent pattern of a 'networked sociality'. It seeks to contribute to the emerging 'mobility turn' within the social sciences.

Automobile Driving↗

Access to specialized health care for asthmatic children in Norway: the significance of parents' educational background and social network.

What determines access to the Voksentoppen Children's Asthma and Allergy Centre, the most specialized health care facility for asthmatic children in Norway? This publicly funded national institution is mandated to serve all segments of the population equally. The paper reports from the experiences of families with children having a confirmed diagnosis of moderate to severe asthma. The study population was selected from a national register of state cash-benefit recipients. Within this register, all families with a child under the age of 9 and with the diagnosis of asthma at the end of 1997 were selected (N = 2564). Further information about the population was gathered in a postal survey. It was found that access to the facility, measured as at least one admission during the period of the disease, was primarily determined by variations in morbidity. In particular, measures of health condition that presupposed a professional's evaluation of the child's health condition were significant. In addition, access was influenced by several factors not directly related to the need for treatment. Notably, children from families in which parents had a graduate education were over-represented among those with access to the top level of the institution's medical hierarchy. Multivariate analysis was used to search for causal mechanisms. It was found that families with a doctor in their social network had greater likelihood of access, and this in part accounted for the observed association between education and access. The pattern of access was also influenced by geographical factors, but not in a way that reduced the significance of educational background. Membership of, and participation in, patient organizations also increased the families' chances of receiving top-level professional treatment. The results depart from professional norms and officially stated health policy in Norway, which assert that health condition is the only valid criterion for allocating scarce medical goods.

Asthma↗

[Quality of attachment representation, social integration and use of social network resources in advanced age].

This study explores a possible biographical basis of interindividual differences in the extent of social integration and use of network resources in old age. Attachment theory was therefore integrated into a sociogerontological research approach. The attachment representations of 48 elderly people were assessed with the Adult Attachment Interview by Main and Goldwyn (31, 56, 57), whereas the subjects' social network was examined using a network questionnaire by Schütze (72). Results indicate that elderly persons' availability as well as use of social resources were, among other things, related to the biographically based attachment representation, which has been shown to be closely connected to emotional experiences usually made in one's family of origin.

Aged↗