Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients.

This study considers social network interactions as a potential source of both stress and support for individuals coping with a chronic illness. The sample consisted of 101 recently-diagnosed rheumatoid arthritis patients. Symptoms of depression were assessed using the Center for Epidemiologic Studies Depression scale. Hierarchical multiple regression analyses examined the conjoint effects of social support and problematic interactions on symptoms of depression. Receipt of positive or helpful support from close friends and family was related to lower depression; receipt of problematic support was related to increased depression. A positive x problematic support interaction suggested that the costs of problematic support do not cancel out the benefits of positive support. Patients who reported both little support and a greater degree of problematic interactions experienced the highest level of symptoms. The findings emphasize the need to consider positive and negative aspects of support transactions conjointly in assessing their stress-reducing and health-protective potential.

[1]  T. Antonucci Social Support: Theoretical Advances, Recent Findings and Pressing Issues , 1985 .

[2]  P. Gertman,et al.  Measuring health status in arthritis. The arthritis impact measurement scales. , 1980, Arthritis and rheumatism.

[3]  R. Moos,et al.  Methodological issues in estimating main and interactive effects: examples from coping/social support and stress field. , 1984, Journal of health and social behavior.

[4]  K. Rook,et al.  The negative side of social interaction: impact on psychological well-being. , 1984, Journal of personality and social psychology.

[5]  C. Goodenow,et al.  Quality of social support and associated social and psychological functioning in women with rheumatoid arthritis. , 1990, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[6]  S. Syme,et al.  Social support and health. , 1986 .

[7]  David J. Abramis,et al.  Effects of Different Sources of Social support and Social Conflict on Emotional Well-Being , 1985 .

[8]  S. Manne,et al.  Spouse criticism and support: their association with coping and psychological adjustment among women with rheumatoid arthritis. , 1989, Journal of personality and social psychology.

[9]  M. Pagel,et al.  Social networks: we get by with (and in spite of) a little help from our friends. , 1987, Journal of personality and social psychology.

[10]  T. Revenson,et al.  Disability and coping as predictors of psychological adjustment to rheumatoid arthritis. , 1989, Journal of consulting and clinical psychology.

[11]  Thomas Ashby Wills,et al.  Supportive functions of interpersonal relationships. , 1985 .

[12]  B. Wallston,et al.  Social support and physical health. , 1983 .

[13]  L. Bradley,et al.  Rheumatoid arthritis: review of psychological factors related to etiology, effects, and treatment. , 1985, Psychological bulletin.

[14]  K. Wallston,et al.  Validity of the Center for Epidemiological Studies Depression Scale in arthritis populations. , 1989, Arthritis and rheumatism.

[15]  Kathleen C. Gerbasi,et al.  Short, homogeneous versions of the Marlow‐Crowne Social Desirability Scale , 1972 .

[16]  N. Beck,et al.  Depression in rheumatoid arthritis. , 1988, The Journal of rheumatology.

[17]  K. Wallston,et al.  Social Support and Depression in Rheumatoid Arthritis: A One-Year Prospective Study1 , 1989 .

[18]  R. Fitzpatrick,et al.  Social relationships and psychological well-being in rheumatoid arthritis. , 1988, Social science & medicine.

[19]  J. Kiecolt-Glaser,et al.  Upsetting social interactions and distress among Alzheimer's disease family care-givers: A replication and extension , 1988, American journal of community psychology.

[20]  P. Gertman,et al.  The arthritis impact measurement scales. Further investigations of a health status measure. , 1982, Arthritis & Rheumatism.

[21]  Going beyond social support: the role of social relationships in adaptation. , 1986 .

[22]  T. Wills,et al.  Stress, social support, and the buffering hypothesis. , 1985, Psychological bulletin.

[23]  L. Dusenbury,et al.  Component social support processes: comments and integration. , 1986, Journal of consulting and clinical psychology.

[24]  J. Becker,et al.  Social network interactions: A buffer or a stress , 1983, American journal of community psychology.

[25]  S. Shoptaw,et al.  Social support, support groups, and the cancer patient. , 1986, Journal of consulting and clinical psychology.

[26]  J. Finch,et al.  Positive and negative social ties among older adults: Measurement models and the prediction of psychological distress and well-being , 1989, American journal of community psychology.

[27]  D. R. Lehman,et al.  The other side of support: Emotional overinvolvement and miscarried helping. , 1988 .

[28]  Marybeth Shinn,et al.  Social Interaction and Social Support , 1984 .

[29]  L. Radloff The CES-D Scale , 1977 .

[30]  Terry L. Conway,et al.  The role of social support in adaptation and recovery from physical illness , 1985 .

[31]  Leonard S. Klibanoff,et al.  Promoting Social Support: The Impact of California's "Friends Can be Good Medicine" Campaign , 1984, Health education quarterly.