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Mental Health in US Adults: The Role of Mental Health in US Adults: The Role of Positive Social Support and Social Positive Social Support and Social

Negativity in Personal RelationshipsNegativity in Personal RelationshipsElizabeth M. Bertera, PhD

Associate ProfessorNational Catholic School of Social Service

The Catholic University of America

Washington DCThis research was funded in part by a grant from

The Catholic University of America.

Presented at APHA, Washington, DC

November 9, 2004

This paper will be published in Vol. 22, Num.1(February, 2005), of the Journal of Social and Personal Relationships.

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Study PurposeStudy Purpose

• Describe how positive social support and social negativity in personal relationships affect mental health in US Adults.

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Background of StudyBackground of Study

• The study is based on data from the National Comorbidity Survey (NCS) (1990-92)

• N = 4,688 adults ages 21-54

• The NCS was a nationally representative survey of the prevalence and correlates of DSM-III-R disorders in the US households.

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Independent VariablesIndependent Variables

• Social Support - 6 Item Index• Chronbach Alpha = .81• Example: Does Spouse (relative or friend) care for

you?

• Social Negativity- 6 Item Index• Chronbach Alpha = .89• Example: How often do your friends (spouse or

relatives) make you feel tense?

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DEPENDENT VARIABLESDEPENDENT VARIABLES(Based on CIDI)(Based on CIDI)

• Anxiety Disorders Index

• Generalized Anxiety Disorder (GAD)

• Panic• Social Phobia• Post Traumatic Stress

Disorder(PTSD)•

Mood Disorders Index

• Depression

• Bi-polar

• Dysthymia

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Sociodemographic CharacteristicsSociodemographic Characteristics

Female Gender 47.8 Median Age 34 Range 21 - 54 Race White 81.1 African American 10. 9 Hispanic 8.0 Education 12 or more years of education 65.5 Annual Income < $20,000 72.3

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Social Negativity Score by Gender and SourceSocial Negativity Score by Gender and Source (P < .001) (P < .001)

13.4713.87

12.4

13.53

12.21

11.66

10.5

11

11.5

12

12.5

13

13.5

14

14.5

MALE FEMALE

Spouse Relatives Friends

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Social Negativity Score by Racial/Ethnic Group Social Negativity Score by Racial/Ethnic Group and Source ( P < .001)and Source ( P < .001)

13.62 13.88 14.1812.95 12.93

11.92 12.13 11.66

13.32

0

2

4

6

8

10

12

14

16

White Afri-American Hispanic

Spouse Relatives Friends

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Social Negativity Score by Years of Education Social Negativity Score by Years of Education and Source (P < .001)and Source (P < .001)

13.97 13.6413.26

19.95

11.62 11.97

0

5

10

15

20

25

0-11 12+

Spouse Relatives Friends

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Social Negativity Score by Income and SourceSocial Negativity Score by Income and Source (P < .001) (P < .001)

14.4513.5313.53

12.7812.2 11.83

0

2

4

6

8

10

12

14

16

<$20,000 >$20,000

Spouse Relatives Friends

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Social Negativity Score by Physical Health and Social Negativity Score by Physical Health and Source (P < .001)Source (P < .001)

0

2

4

6

8

10

12

14

16

Poor Fair Good Very Good Excellent

Spouse Relatives Friends

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Positive Social Support Scores by Gender and Positive Social Support Scores by Gender and Source ( P < .001)Source ( P < .001)

22.78

22

20.3720.79

19.72

20.73

18

19

20

21

22

23

24

Male Female

Spouse Relatives Friends

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Positive Social Support Scores Positive Social Support Scores by Race/Ethnicity and Source ( P < .001) by Race/Ethnicity and Source ( P < .001)

22.4321.98 21.92

20.66 20.4720

20.4

19.3319.89

17

18

19

20

21

22

23

White Afri-American Hispanic

Spouse Relatives Friends

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Positive Social Support Scores by Years of Positive Social Support Scores by Years of Education and Source ( P < .001)Education and Source ( P < .001)

21.9322.43

19.59

20.73

19.08

20.41

17

18

19

20

21

22

23

0-11 12+

Spouse Relatives Friends

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Positive Social Support Scores by Income and Positive Social Support Scores by Income and Source (P < .001)Source (P < .001)

21.78

22.48

20.02

20.81

19.8120.41

1818.5

1919.5

2020.5

2121.5

2222.5

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<$20,000 >$20,000

Spouse Relatives Friends

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Positive Social Support Scores by Physical Health Positive Social Support Scores by Physical Health and Source (P < .001) and Source (P < .001)

0

5

10

15

20

25

Poor Fair Good Very Good Excellent

Spouse Relatives Friends

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Standardized Regression Coefficients for variables Standardized Regression Coefficients for variables predicting the number of Anxiety and Mood predicting the number of Anxiety and Mood

Disorder Episodes (*P < .001)Disorder Episodes (*P < .001)

Variable Anxiety Disorder

Mood

Disorders

Positive SS Spouse -0.14 -0.04

Relatives -0.28 * -0.39 *

Friends -0.15 -0.03

Negative SS Spouse 0.39 * 0.42 *

Relatives 0.32 * 0.27 *

Friends 0.17 * 0.23 *

Total R2 0.26 * 0.19 *

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FindingsFindings

• Both positive and negative social exchanges were associated with social, demographic and physical health characteristics.

• The level of physical health indicated strong, graded, and inverse relationship with social negativity scores.

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FindingsFindings

• There were significant differences in social negativity scores by gender, income and physical health for all three social network sources.

• Female respondents reported significantly more perceived social negativity from spouses and from relatives and less from friends compared to males.

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FindingsFindingsIn general, female gender, lower education,

lower income, and poorer physical health were associated with more perceived social negativity.

White racial group, more education, higher incomes, and better physical health were associated with more perceived positive social support.

Males had more positive social support from spouses, while females had more positive social support from relatives and friends.

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ImplicationsImplications

• This study confirms the need to understand both the sources and types of social support that exist in social exchanges.

• In assessing the social relationships of clients with mental disorders it is important to not only assess positive social support but sources and circumstances of social negativity as well.

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ImplicationsImplications

• The presence of social negativity with network members can introduce stress into relationships, while the lack of social support may leave individuals without protective buffers, especially when confronted with social-emotional stressors.

• The community mental health movement and changing public perceptions have increased the population of clients requesting mental health services. Improved social support is an intervention that could be incorporated into existing diagnostic, treatment and prevention efforts.