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Middle-Eastern immigrant parents' social networks and help-seeking for child health care.

The purpose of this research was to describe: (a) Arab-American immigrant parents' perceptions of their social networks, including social support; and (b) Arab-American immigrant parents' perceptions of their help-seeking related to child health care. Seventy-three immigrant parents who were Egyptian-American (n = 17), Palestinian-American (n = 44) and Yemeni-American (n = 12) completed the Norbeck Social Support Questionnaire, four Supplementary Social Support Questions, a Support System Map and a Child Health Interview Guide. Family and relatives were perceived as the major source of support and comprised the highest percentage of social network members. Compared with published scores of a normative American sample, the immigrant parents' scores were lower (P less than 0.01) on all social network and social support variables. There was a moderate negative correlation (r = 0.47) between parents' number of years of residence in the USA and percentage of network members living outside the USA (P less than 0.01) and a weak positive correlation (r = 0.36) between number of years in the USA and percentage of network members living close to the parent (P less than 0.01). Parents' help-seeking for child health care involved use of a variety of resources, with reliance on some long-distance support from family in the Middle-East. This descriptive research provides a basis for further research on patterns of support and help-seeking in immigrant parents.

Adolescent↗

A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA.

STUDY OBJECTIVE: Previous studies have established a relationship between low levels of social networks and total mortality, but few have examined cause specific mortality or disease incidence. This study aimed to examine prospectively the relationships between social networks and total and cause specific mortality, as well as cardiovascular disease incidence. DESIGN: This was a four year follow up study in an ongoing cohort of men, for whom information on social networks was collected at baseline. The main outcome measures were total mortality, further categorised into deaths from cardiovascular disease (stroke and coronary heart disease), total cancer, accidents/suicides, and all other causes; as well as stroke and coronary heart disease incidence. PARTICIPANTS: Altogether 32,624 US male health professionals aged 42 to 77 years in 1988, who were free of coronary heart disease, stroke, and cancer at baseline. RESULTS: A total of 511 deaths occurred during 122,911 person years of follow up. Compared with men with the highest level of social networks, socially isolated men (not married, fewer than six friends or relatives, no membership in church or community groups) were at increased risk for cardiovascular disease mortality (age adjusted relative risk, 1.90; 95% CI 1.07, 3.37) and deaths from accidents and suicides (age adjusted relative risk 2.22; 95% CI 0.76, 6.47). No excess risks were found for other causes of death. Socially isolated men were also at increased risk of stroke incidence (relative risk, 2.21; 95% CI, 1.12, 4.35), but not incidence of non-fatal myocardial infarction. CONCLUSIONS: Social networks were associated with lower total mortality by reducing deaths from cardiovascular disease and accidents/suicides. Strong social networks were associated with reduced incidence of stroke, though not of coronary heart disease. However, social networks may assist in prolonging the survival of men with established coronary heart disease.

Accidents↗

Social networks and mental health: on overview.

Research has shown that social networks can act as social support systems to promote mental health and buffer psychological stress. In this selective review the authors illuminate patterns and characteristics of social networks that maintain health and help prevent illness, explore the relationship between social networks and the course and outcome of treatment for mental illness, and describe clinical network interventions that have been used to facilitate inpatient care and maximize performance of ex-patients in the community. The authors also discuss the implications of research findings for mental health practice.

Community Mental Health Services↗

The biocultural context of social networks and depression among the elderly.

The association between the size and structure of social networks and the prevalence of depressive symptoms was examined in a population-based study of 1615 men and women age 65 years and older. Age was significantly associated with marital status, social network index quartile, and the social relationship to the primary source of support. Women and men differed with respect to current marital status, number of close friends and relatives, frequency of face-to-face contact, and participation in voluntary associations and religious institutions. Regardless of their marital status, women were also less likely than men to point to a spouse as their primary source of support. Beck Depression Inventory mean scores and rates of depressive symptoms were inversely associated with social network index and participation in voluntary associations and religious institutions for both men and women. Individuals with no primary source of support or who depended on a relative had significantly higher than expected mean scores and rates of depressive symptoms. Both social network index and social distance to primary source of support were independently associated with depression after controlling for age, sex, and number of chronic conditions. Participation in voluntary associations, social distance from primary source of support, church membership, and number of close friends were also significant independent predictors of depressive symptoms. Results indicate that depressive symptoms are inversely associated with the size of social networks. The structure of these networks, in turn, is influenced by biological factors such as age, physical disability, and mortality of network members, and by culturally-determined rules that define the individuals and institutions available for support. However, these rules appear to differ for men and women.

Aged↗

The role of social networks and support in postpartum women's depression: a multiethnic urban sample.

OBJECTIVES: This study examined the relationship of social support, and of social networks, to symptoms of depression in a multiethnic sample of women having recently given birth. METHODS: Women at community health centers in a Northeastern city were randomly sampled from groups stratified by race/ethnicity (African American, Hispanic, and White) and postpartum interval. Mother's score on the Center for Epidemiologic Studies of Depression Scale (CES-D) was the dependent variable. Main independent variables included the Medical Outcomes Study (MOS) Social Support Survey and a social network item. Univariate statistics assessed the relationship between CES-D score and each of the independent variables. Multivariate linear regression models included core sociodemographic variables alone, the core model with each of the social support and social network variables added separately, and all variables together. We evaluated interactions between race and social support, race and social networks, and social support and social networks. RESULTS: The multivariate models with MOS Social Support and core variables indicated that each 10-point increase in the MOS Social Support Survey was related to a 2.1-unit lower score on the CES-D (95% CI -2.4, -1.7). The inclusion of the social network variable into the core model showed that having two or more friends or family members available was associated with a 13.6-point lower mean score on the CES-D (95% CI -17.5, -9.6), compared to women reporting none or only one available person. CONCLUSIONS: Both social support and social networks were statistically significant and independently related to depressive symptomatology.

Adult↗

[Social networks in schizophrenic disorders--a review].

In the fifties the "social network"-concept was developed in order to improve the analysis of the structure of different social groups; later on, its emphasis has shifted to the study of "personal networks", that deal with the structure of the social relations of a "focal individual". In the latter sense the term "social network" will be used in this paper. Social networks are discussed in terms of morphological characteristics such as the size or the number of clusters as well as in terms of interactional characteristics such as the number of social contacts of the focal person. Studies concerning the social networks of schizophrenics that have been carried out so far showed the following results: In comparison with the social networks of the mentally healthy those of schizophrenic patients are markedly smaller in size and contain a smaller number of clusters. The proportion of family members in the social networks of schizophrenics is higher than in those of the mentally healthy. Social relations of the latter generally show a more complex structure than those of the schizophrenics. The social networks of schizophrenics patients with multiple admissions are generally smaller than those of first admission schizophrenic patients who also have more extrafamilial contacts. -The last section of this paper discusses methodical problems of the existing studies that deal with the social networks of schizophrenic patients; some suggestions are made concerning the application of the network-concept to psychiatric therapy.

Family↗

Is the social network analysis necessary in the rehabilitation of individuals with head injury?

A social network is a support system in which one can obtain assistance for simple daily needs and in emergency situations. A diminished social network can result in failure to integrate into normalized environments. The results of this investigation clearly showed that social networks among a group of 70 people who were traumatically brain injured had significantly fewer members than a control group of non-injured respondents. Additionally, the make-up of social networks was different. Specifically, respondents who were traumatically brain injured had social networks consisting mainly of family and staff members of the rehabilitation facility, while non-injured respondents had mostly friends or acquaintances, coworkers, and family members, in that order.

Adolescent↗

Social networks and mental illness in a peasant society.

Social networks of 35 mentally ill persons were studied in Lao villages. Mental illness was associated with a decrease in size of social networks, disproportionate reliance on family, and asymmetric instrumental exchange. Nonkin "sponsors" provided assistance to those alienated from or abandoned by relatives. For those with late onset or episodic course, past accumulation of "social reserve" or "social capital" favored continuation of large networks. Size of social network was positively correlated with social function but bore little relation to psychopathology.

Adult↗

Social networks and risk of neural tube defects.

The contribution of social support and social networks to risk of neural tube defects (NTDs) has not been explored, despite evidence that various aspects of the social environment contribute to their etiology. Using data from a population-based case-control study of deliveries occurring in California from 1989 to 1991, this study investigates whether social networks, as measured by the presence and frequency of various types of social contacts, are associated with NTD risk. In-person interviews were conducted with 538 (88% of eligible) mothers of NTD cases and with mothers of 539 non-malformed controls (88%) on average 5 months from the term delivery date. Unadjusted results indicate that women who reported having close friends, close relatives, or monthly contacts with close friends or relatives had 30-70% lower risks of having NTD-affected pregnancies, relative to women reporting 'none' to any of these measures. Only the presence of close friends was associated with reduced NTD risk after adjustment for other aspects of the social network and several potential covariates. This study is the first to investigate the association between social networks and risk of NTDs. Stronger inferences await replication and extension of these results.

California↗

Risk reconsidered: targets of violence in the social networks of people with serious psychiatric disorders.

Risk Reconsidered: Targets of violence in the Social Networks of People with Serious Mental illness. This exploratory analysis addresses the questions: 1) Who among the members of the social network of a person diagnosed with a major psychiatric disorder is likely to become a target of violence? 2) What kind of relationships do targets have with respondents in terms of the quality and quantity of interactions?, and 3) What are the risk factors that contribute to being a target of violence for people who are in the social networks of persons with serious mental disorders? The samples of 169 people with serious mental disorders were followed for 30 months. A logistic regression model of the risk for being a target of violence among the members of the cohort's social network reveals that both target and respondent characteristics are salient, and that mothers who live with adult children who have schizophrenia and co-occurring substance abuse bear a substantially elevated risk of becoming a target of violence, compared to other social network members. Other factors that elevate the risk for being a target of violence are being an immediate family members of the respondent, more time in residence with the respondent, and whether the respondent is financially dependent on the family. Respondents with the most mental health center visits had lower odds of committing an act or threat of violence against a social network member.

Adult↗

Clinical issues in social network therapy for clients with schizophrenia.

Social networks are viable foci for therapeutic interventions. A social network therapy program for clients with schizophrenia was developed by a community-based mental health agency. This paper presents four of the most common clinical issues encountered and illustrates each with a case example.

Adult↗

Women's perception of changes in the social network after a spinal cord injury.

PURPOSE: To describe how women with a spinal cord injury (SCI) perceived changes in the social network, and how these changes affected their ability to participate in occupation. METHOD: Thirteen women, aged 25 to 61 years, with a SCI were interviewed twice. The interviews focused on their ability to participate in occupation, their relations with individuals within the social network, and changes in the social network following the SCI. The analysis was carried out using qualitative content analysis. RESULTS: The women described an emotional need for social support after the SCI to participate in occupation. This was a new experience that required time to adapt to. The women also described a need for practical social support from the social network members to manage meaningful occupation. After the SCI, the women had developed new habits through close cooperation with members in the social network. The women felt that they had become more responsible for the development of their relations. Many relations had improved after the SCI, while some had decreased. The women had also developed new relations with other persons with disabilities. CONCLUSIONS: The women perceived substantial changes in the social network following the SCI, which in several ways affected their ability to participate in occupation. To adapt to their new life situation, the women gradually developed different strategies. The results point out the need to identify persons in the social network that women with SCI develop relations with, and integrate them in the rehabilitation process.

Adult↗

Identifying the role that animals play in their social networks.

Techniques recently developed for the analysis of human social networks are applied to the social network of bottlenose dolphins living in Doubtful Sound, New Zealand. We identify communities and subcommunities within the dolphin population and present evidence that sex- and age-related homophily play a role in the formation of clusters of preferred companionship. We also identify brokers who act as links between sub-communities and who appear to be crucial to the social cohesion of the population as a whole. The network is found to be similar to human social networks in some respects but different in some others, such as the level of assortative mixing by degree within the population. This difference elucidates some of the means by which the network forms and evolves.

Age Factors↗

Do recent-onset schizophrenia patients experience a "social network crisis"?

It has been proposed that the onset of schizophrenia creates a social network crisis, resulting in a dramatic deterioration of social resources during the period immediately following a first hospitalization from essentially normal pre-hospitalization levels. To evaluate this proposal, recent onset patients (n = 89) completed comprehensive assessments that examined their social networks in the 12 months prior to first hospitalization and, in a subset of patients (n = 34), at a 15-month follow-up. Cross-sectional relationships to social functioning and symptoms were examined at both time points. Compared to existing research, at the initial assessment patients were characterized by several network disturbances, including small network size, a high proportion of family members, and highly dense interconnections among network members; these disturbances generally remained moderately to highly stable at follow-up. Smaller social networks were related to poor current and premorbid social functioning and aspects of clinical functioning, particularly at the 15-month follow-up assessment. Thus, this first repeated assessment of social network characteristics in the early course of schizophrenia does not support the social network crisis concept. Instead, results suggest that functionally relevant social network disturbances often exist by the time of first hospitalization in schizophrenia.

Adult↗

Social network and blood pressure: a population study.

The relationship between social network and blood pressure was assessed in a cross-sectional, random sample of 1409 white adults aged 20 to 70 years studied in Buffalo in 1961. Higher total social network scores were associated with lower systolic and diastolic blood pressure in both males and females. Considering the components of social network separately, increased size of household and greater participation in clubs were associated with lower systolic blood pressure for males, with the trend in the same direction for women, though not reaching statistical significance. Among females, the only social network component showing significant linear trend was the number of siblings, with increased number of siblings being associated with lower systolic and diastolic blood pressure. Religious service attendance and marital status were not associated with blood pressure in this population.

Adult↗

Assessment of stress-buffering effects of social networks on psychological symptoms in an inner-city elderly population.

Social network researchers have been divided into two camps: those who propose that social networks have a direct effect on subsequent psychological symptoms and those who posit a stress-buffering effect as well. Previous research has been limited by rudimentary measures of social interaction and the absence of longitudinal data as well as by different approaches to the assessment of possible buffering effects. In the present study, using 19 social network variables, the authors followed 133 elderly residents of mid-Manhattan SRO hotels for 1 year. Three different methods of determining buffering effects were examined: Dividing the sample into high- and low-stress groups and contrasting differences in percentage variance accounted for by social networks between the two groups; Examining the group as a whole to assess if any Network Variable X Stress interactional terms are significant; Examining the group as a whole to assess whether there is a reduction in the beta value of stress with respect to psychological symptoms when network variables are added to the analysis. Method 1 indicated a direct network effect, but none of the methods indicated a buffering effect. Of clinical relevance was the nonlinearity of the network effects, that is, depending upon a person's stressor level, different network dimensions must be emphasized and strengthened.

Adaptation, Psychological↗

Social network as a predictor of hospital readmission and mortality among older patients with heart failure.

BACKGROUND: This study examines the relationship between social network and hospital readmission and mortality in older patients with heart failure. METHODS AND RESULTS: Prospective study conducted with 371 patients, age 65 and older, admitted for heart failure-related emergencies at 4 Spanish hospitals. Social network was measured at baseline with a 4-item questionnaire that ascertained whether subjects were married, lived with another person(s), saw or had telephone contact with family members daily or almost daily, and were at home alone for less than 2 hours per day. Social network was deemed "high" where all 4 items were present, "moderate" where 3 were present, and "low" where 2 or fewer were present. Analyses were performed using Cox models, and adjusted for the main confounders. A total of 55% of patients had high or moderate social networks. During a median follow-up of 6.5 months, 135 (36.4%) patients underwent a first emergency rehospitalization and 68 (18.3%) died. Compared with patients with high social network, hospital readmission was more frequent among those who had moderate (hazard ratio [HR] 1.87; 95% confidence interval [CI] 1.06-3.29; P < .05) and low social networks (HR 1.98; 95% CI 1.07-3.68; P < .05). This relationship showed a positive dose-response (p for linear trend 0.042). The magnitude of this association was comparable to that of other important predictors of readmission, such as previous hospitalization. No relationship was observed between social network and death. CONCLUSION: A very simple questionnaire measuring social network can identify patients with a higher short-term risk of hospital readmission.

Aged↗

The role of caregiver social networks in Alzheimer's disease.

Although the theoretical importance of social networks in alleviating caregivers' mental distress when a family member has Alzheimer's disease is well-established, empirical support has been less definitive. For 58 patient-spouse caregiver dyads, we used an array of network variables within a causal model of stress. We found that: caregiver networks are associated with severity of illness but not duration; increased illness severity was associated with network members assuming new roles; social networks had indirect effects but no direct or buffering effects on caregiver psychological distress; religious attendance had direct and indirect effects on caregiver psychological distress. These findings point to the important, but complex, role that social networks play in affecting caregivers. However, because of its cross-sectional nature and the relatively small sample size, this study will require replication on larger samples using longitudinal analyses.

Adaptation, Psychological↗