One hundred and fifty middle-aged and elderly adults with a diagnosis of major depression were assessed initially as in-patients, and were reinterviewed 6-32 months later Both size of social network and subjective social support were significant predictors of depressive symptoms at follow-up, with baseline depression scores and other predictors of outcome status statistically controlled Subjective social support was most strongly associated with major depression; this effect was significantly stronger for middle-aged than older adults, and for men than women Differences in the effects of marital status, size of social network, and subjective social support also suggest the importance of distinguishing between involvement in and quality of interpersonal relationships

Social support and the outcome of major depression.

Objective: To compare outcomes in psychoeducational multiple-family group treatment vs psychoeducational single-family treatment. Method: A total of 172 acutely psychotic patients, aged 18 to 45 years, withDSM-III-Rschizophrenic disorders were randomly assigned to single- or multiple-family psychoeducational treatment at six public hospitals in the state of New York. Psychotic relapse, symptom status, medication compliance, rehospitalization, and employment were assessed independently during 2 years of supervised treatment. Results: The multiple-family groups yielded significantly lower 2-year cumulative relapse rates than did the single-family modality (16% vs 27%) and achieved markedly lower rates in patients whose conditions had not remitted at index hospital discharge (13% vs 33%). The relapse hazard ratio between treatments was 1:3. The relapse rate for both modalities was less than half the expected rate (65% to 80% for 2 years) for patients receiving individual treatment and medication. Rehospitalization rates and psychotic symptoms decreased significantly, and medication compliance was high, to an equal degree in both modalities. Psychoeducational multiple-family groups were more effective than single-family treatment in extending remission, especially in patients at higher risk for relapse, with a cost-benefit ratio of up to 1:34. Conclusion: Psychoeducational multiple-family groups were more effective than single-family treatment in extending remission, especially in patients at higher risk for relapse, with a cost-benefit ratio of up to 1:34.

Multiple-family groups and psychoeducation in the treatment of schizophrenia.

This study documented the types and extent of social support messages exchanged by persons with disabilities who participated in a computer-based support group. A modified version of Cutrona & Suhr's (1992) social support category system was used to code 1,472 support messages. The largest percentage of these messages offered emotional and informational support, whereas network support and tangible assistance were least frequently offered. It appeared that many of the support messages directly redressed limitations and challenges associated with disability-related mobility, socialization, and self-care. Results are discussed in terms of the generalizability of existing category systems for coding support to this mediated context, the relative importance of different types of support in the communication of support group members, and the unique features of social support in mediated environments. The implications of this study for social support researchers, persons with disabilities, and human services professionals are also discussed.

/pdf/communication-of-social-support-in-computer-mediated-groups-1kc9qwmke6.pdf

Communication of Social Support in Computer-Mediated Groups for People With Disabilities

This study examines the relationship between objective and subjective measures of social support with recovery from serious mental illness; recovery has been described as both an outcome state and an ongoing process. One hundred and seventy six people with serious mental illness completed the Recovery Assessment Scale, a process measure of recovery that assessed, among other factors, personal confidence, goal orientation, and non-domination by symptoms. They also were administered the Brief Psychiatric Rating Scale, a semi-structured interview that assesses psychiatric symptom and represents recovery as an outcome. Finally, research participants completed the Social Network Scale, which assessed size of the overall network plus such important subnetworks as family, friends, and health professionals. The SNS also provided measures of the perceived satisfaction with, mutuality in, and obligation towards individuals in their support network. Results showed people with larger overall network size and more network satisfaction were likely to report higher factors on the Recovery Assessment Scale. For the most part, network size and satisfaction was not significantly associated with psychiatric symptoms. Implications of these findings for better understanding the association between social support and recovery are discussed.

Social support and recovery in people with serious mental illnesses.

Quantitative and qualitative aspects of the social network were investigated in a sample of 120 schizophrenic out-patients. Sociodemographic and clinical factors as well as subjective quality of life were investigated as to their relationship to the social network. The Interview Schedule for Social Integration (ISSI) was used to assess social network and Lancashire Quality of Life Profile was used to assess subjective quality of life. Psychopathology was measured by BPRS and psychosocial functioning by GAF. The patients reported a significantly worse social network compared to a normal sample both regarding quantitative and qualitative aspects of the network. Almost half of the patients wanted access to more social contacts. Relatives and friends turned out to be the patient's main source of supportive contacts. More severe negative and positive symptoms were related to a worse social network. Support was found for an association between characteristics of the social network, such as satisfaction with social contacts, and quality of life. The results give reason to suggest that the care system should consider the informal caregivers' situation and focus on interventions, which enhance the patient's satisfaction with social contacts.

Quantitative and qualitative aspects of the social network in schizophrenic patients living in the community. Relationship to sociodemographic characteristics and clinical factors and subjective quality of life.

Social Network Mediation of Anxiety

Social network analysis is a concept leading to a description of the social relations that obtain between people. The personal or egocentric social network is the focus of this analysis. Features of a social network include both structural and interactional variables. The clinical significance of social networks may be supportive or destructive. A typological model is presented as a heuristic method toward a clinical theory.

Models of social network intervention

This paper examines the concept of social network as a mediating construct linking psychiatric epidemiology and community mental health. A selective review of studies investigating the structural and interactional features of the social networks of psychiatrically impaired persons is presented and the implications of their results are discussed. It is concluded that social networks provide a unifying framework potentially capable of linking empirical research with clinical practice.

Robert Llamas

Papers

Social Network Mediation of Anxiety

Models of social network intervention

Social Networks: A Link between Psychiatric Epidemiology and Community Mental Health.