Social ties and mental health.
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Journal: 2001/October - Journal of Urban Health
ISSN: 1099-3460
Abstract:
It is generally agreed that social ties play a beneficial role in the maintenance of psychological well-being. In this targeted review, we highlight four sets of insights that emerge from the literature on social ties and mental health outcomes (defined as stress reactions, psychological well-being, and psychological distress, including depressive symptoms and anxiety). First, the pathways by which social networks and social supports influence mental health can be described by two alternative (although not mutually exclusive) causal models-the main effect model and the stress-buffering model. Second, the protective effects of social ties on mental health are not uniform across groups in society. Gender differences in support derived from social network participation may partly account for the higher prevalence of psychological distress among women compared to men. Social connections may paradoxically increase levels of mental illness symptoms among women with low resources, especially if such connections entail role strain associated with obligations to provide social support to others. Third, egocentric networks are nested within a broader structure of social relationships. The notion of social capital embraces the embeddedness of individual social ties within the broader social structure. Fourth, despite some successes reported in social support interventions to enhance mental health, further work is needed to deepen our understanding of the design, timing, and dose of interventions that work, as well as the characteristics of individuals who benefit the most.
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J Urban Health 78(3): 458-467
PMID: 11564849

Social ties and mental health

Abstract

It is generally agreed that social ties play a beneficial role in the maintenance of psychological well-being. In this targeted review, we highlight four sets of insights that emerge from the literature on social ties and mental health outcomes (defined as stress reactions, psychological well-being, and psychological distress, including depressive symptoms and anxiety). First, the pathways by which social networks and social supports influence mental health can be described by two alternative (although not mutually exclusive) causal models—the main effect model and the stress-buffering model. Second, the protective effects of social ties on mental health are not uniform across groups in society. Gender differences in support derived from social network participation may partly account for the higher prevalence of psychological distress among women compared to men. Social connections may paradoxically increase levels of mental illness symptoms among women with low resources, especially if such connections entail role strain associated with obligations to provide social support to others. Third, egocentric networks are nested within a broader structure of social relationships. The notion of social capital embraces the embeddedness of individual social ties within the broader social structure. Fourth, despite some successes reported in social support interventions to enhance mental health, further work is needed to deepen our understanding of the design, timing, and dose of interventions that work, as well as the characteristics of individuals who benefit the most.

Keywords: Mental health, Psychological distress, Social capital, Social integration, Social ties

Abstract

It is generally agreed that social ties play a beneficial role in the maintenance of psychological well-being. In this targeted review, we highlight four sets of insights that emerge from the literature on social ties and mental health outcomes (defined as stress reactions, psychological well-being, and psychological distress, including depressive symptoms and anxiety). First, the pathways by which social networks and social supports influence mental health can be described by two alternative (although not mutually exclusive) causal models—the main effect model and the stress-buffering model. Second, the protective effects of social ties on mental health are not uniform across groups in society. Gender differences in support derived from social network participation may partly account for the higher prevalence of psychological distress among women compared to men. Social connections may paradoxically increase levels of mental illness symptoms among women with low resources, especially if such connections entail role strain associated with obligations to provide social support to others. Third, egocentric networks are nested within a broader structure of social relationships. The notion of social capital embraces the embeddedness of individual social ties within the broader social structure. Fourth, despite some successes reported in social support interventions to enhance mental health, further work is needed to deepen our understanding of the design, timing, and dose of interventions that work, as well as the characteristics of individuals who benefit the most.

Keywords: Mental health, Psychological distress, Social capital, Social integration, Social ties

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
1. Durkheim E. Suicide. New York: Free Press; 1951. [Google Scholar]
2. Barnett PA, Gotlib IH. Psychosocial functioning and depression: distinguishing among antecedents, concomitants, and consequences. Psychol Bull. 1988;104:97–126. doi: 10.1037/0033-2909.104.1.97. [PubMed] [CrossRef] [Google Scholar]
3. Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98:310–357. doi: 10.1037/0033-2909.98.2.310. [PubMed] [CrossRef] [Google Scholar]
4. Berkman LF, Glass T. Social integration, social networks, social support, and health. In: Berkman LF, Kawachi I, editors. Social Epidemiology. New York: Oxford University Press; 2000. pp. 137–173. [Google Scholar]
5. Cohen S, Underwood LG, Gottlieb BH. Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000. [Google Scholar]
6. Lin N, Ye X, Ensel WM. Social support and depressed mood: a structural analysis. J Health Soc Behav. 1999;40:344–359. doi: 10.2307/2676330. [PubMed] [CrossRef] [Google Scholar]
7. Thoits PA. Social support as coping assistance. J Consult Clin Psychol. 1986;54:416–423. doi: 10.1037/0022-006X.54.4.416. [PubMed] [CrossRef] [Google Scholar]
8. Kamarck T., Manuck S, Jennings J. Social support reduces cardiovascular reactivity to psychological challenge: a laboratory model. Psychosom Med. 1990;52:42–58. [PubMed] [Google Scholar]
9. Kaslow NJ, Deering CG, Racusin GR. Depressed children and their families. Clin Psychol Rev. 1994;14:39–59. doi: 10.1016/0272-7358(94)90047-7. [CrossRef] [Google Scholar]
10. Bowlby J. Attachment and Loss. London, England: Hogarth Press; 1973. [Google Scholar]
11. Gunnar MR, Nelson CA. Event-related potentials in year-old infants: relations with emotionality and cortisol. Child Dev. 1994;65:80–94. doi: 10.2307/1131367. [PubMed] [CrossRef] [Google Scholar]
12. Oxman T E, Berkman LF, Kasl S, Freeman DH, Jr, Barrett J. Social support and depressive symptoms in the elderly. Am J Epidemiol. 1992;135:356–368. [PubMed] [Google Scholar]
13. Lee GR. Kinship and social support of the elderly: the case of the United States. Aging Soc. 1985;5:19–38. doi: 10.1017/S0144686X00011272. [CrossRef] [Google Scholar]
14. Rook KS. The negative side of social interaction. J Pers Soc. Psychol. 1984;46:1097–1108. doi: 10.1037/0022-3514.46.5.1097. [PubMed] [CrossRef] [Google Scholar]
15. Fabrigoule C, Letenneur L, Dartigues J, Zarrouk M, Commenges D, Barberger-Gateau P. Social and leisure activities and risk of dementia: a prospective longitudinal study. J Am Geriatr Soc. 1995;43:485–490. [PubMed] [Google Scholar]
16. Bassuk S, Glass T, Berkman L. Social disengagement and incident cognitive decline in community-dwelling elderly persons. Ann Intern Med. 1999;131:165–173. [PubMed] [Google Scholar]
17. Fratiglioni L, Wang H, Ericsson K, Maytan M, Winblad B. The influence of social network on the occurrence of dementia: a community-based longitudinal study. Lancet. 2000;355:1315–1315. doi: 10.1016/S0140-6736(00)02113-9. [PubMed] [CrossRef] [Google Scholar]
18. Wethington E, McLeod JD, Kessler RC. The importance of life events for explaining sex differences in psychological distress. In: Barnett RC, Biener L, Baruch GK, editors. Gender and Stress. New York: The Free Press; 1987. pp. 144–156. [Google Scholar]
19. Belle D. Gender differences in the social moderators of stress. In: Barnett RC, Biener L, Baruch GK, editors. Gender and Stress. New York: The Free Press; 1987. pp. 257–277. [Google Scholar]
20. Belle D. Lives in Stress: Women and Depression. Beverly Hills, CA: Sage; 1982. [Google Scholar]
21. Stroebe MS, Stroebe W. Who suffers more? Sex differences in health risks of the widowed. Psychol Bull. 1983;93:279–301. doi: 10.1037/0033-2909.93.2.279. [PubMed] [CrossRef] [Google Scholar]
22. Lowenthal MJ, Haven C. Interaction and adaptation: intimacy as a critical variable. Am Sociol Rev. 1968;33:20–30. doi: 10.2307/2092237. [PubMed] [CrossRef] [Google Scholar]
23. Belle D. The impact of poverty on social networks and supports. Marriage Fam Rev. 1983;5:89–103. doi: 10.1300/J002v05n04_06. [CrossRef] [Google Scholar]
24. Dressler WW, Badger LW. Epidemiology of depressive symptoms in black communities. J Nerv Ment Dis. 1985;173:212–220. doi: 10.1097/00005053-198504000-00002. [PubMed] [CrossRef] [Google Scholar]
25. Corin E. The cultural frame: context and meaning in the construction of health. In: Amick BC III, Levine S, Tarlov AR, Chapman Walsh D, editors. Society and Health. New York: Oxford University Press; 1985. pp. 272–304. [Google Scholar]
26. Boissevain J. Friends of Friends. New York: St. Martin's Press; 1974. [Google Scholar]
27. Berkman LF. The role of social relations in health promotion. Psychosom Med. 1995;57:245–254. [PubMed] [Google Scholar]
28. Faris REL, Dunham HW. Mental Disorders in Urban Areas. New York: Hafner; 1939. [Google Scholar]
29. Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D. Social capital, income inequality, and mortality. Am J Public Health. 1997;87:1491–1498. doi: 10.2105/AJPH.87.9.1491.[PMC free article] [PubMed] [CrossRef] [Google Scholar]
30. Kawachi I, Berkman LF. Social cohesion, social capital, and health. In: Berkman LF, Kawachi I, editors. Social Epidemiology. New York: Oxford University Press; 2000. pp. 174–190. [Google Scholar]
31. Brown GW, Harris TO. Social Origins of Depression: a Study of Psychiatric Disorder in Women. London: Tavistock; 1978. [Google Scholar]
32. Vachon M, Lyall W, Rogers J. A controlled study of self-help intervention for widows. Am J Psychiatry. 1980;137:1380–1384. [PubMed] [Google Scholar]
33. Mittleman MS, Ferris SH, Shulman E, et al. A comprehensive support program: effect on depression in spouse-caregivers of AD patients. Gerontologist. 1995;35:792–802. [PubMed] [Google Scholar]
34. Heller K, Thompson MG, Trueba PE, Hogg JR, Vlachos-Weber I. Peer support telephone dyads for elderly women: was this the wrong intervention? Am J Community Psychol. 1991;93:53–74. doi: 10.1007/BF00942253. [PubMed] [CrossRef] [Google Scholar]
35. Harris T, Brown GW, Robinson R. Befriending as an intervention for chronic depression among women in an inner city. I. Randomized controlled trial. Br J Psychiatry. 1999;174:219–224. doi: 10.1192/bjp.174.3.219. [PubMed] [CrossRef] [Google Scholar]
36. Brand EF, Lakey B, Berman S. A preventive, psychoeducational approach to increase perceived social support. Am J Community Psychol. 1995;23:117–135. doi: 10.1007/BF02506925. [PubMed] [CrossRef] [Google Scholar]
37. Cohen S, Gottlieb BH, Underwood LG. Social relationships and health. In: Cohen S, Underwood LG, Gottlieb BH, editors. Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000. pp. 3–25. [Google Scholar]
38. Rook KS, Underwood LG. Social support measurement and interventions. Comments and future directions. In: Cohen S, Underwood LG, Gottlieb BH, editors. Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000. pp. 311–334. [Google Scholar]
39. Gottlieb BH. Selecting and planning support interventions. In: Cohen S, Underwood LG, Gottlieb BH, editors. Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000. pp. 195–220. [Google Scholar]
Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Avenue, 02115 Boston, MA
Ichiro Kawachi, Email: ude.dravrah.gninnahc@ihcawaK.orihcI.
Corresponding author.
Copyright © The New York Academy of Medicine 2001
Full Text

References

  • 1. Durkheim E Suicide. New York: Free Press; 1951. [PubMed][Google Scholar]
  • 2. Barnett PA, Gotlib IHPsychosocial functioning and depression: distinguishing among antecedents, concomitants, and consequences. Psychol Bull. 1988;104:97–126. doi: 10.1037/0033-2909.104.1.97.] [[PubMed][Google Scholar]
  • 3. Cohen S, Wills TAStress, social support, and the buffering hypothesis. Psychol Bull. 1985;98:310–357. doi: 10.1037/0033-2909.98.2.310.] [[PubMed][Google Scholar]
  • 4. Berkman LF, Glass T. Social integration, social networks, social support, and health. In: Berkman LF, Kawachi I, editors. Social Epidemiology. New York: Oxford University Press; 2000. pp. 137–173. [PubMed]
  • 5. Cohen S, Underwood LG, Gottlieb BH Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000. [PubMed][Google Scholar]
  • 6. Lin N, Ye X, Ensel WMSocial support and depressed mood: a structural analysis. J Health Soc Behav. 1999;40:344–359. doi: 10.2307/2676330.] [[PubMed][Google Scholar]
  • 7. Thoits PASocial support as coping assistance. J Consult Clin Psychol. 1986;54:416–423. doi: 10.1037/0022-006X.54.4.416.] [[PubMed][Google Scholar]
  • 8. Kamarck T., Manuck S, Jennings JSocial support reduces cardiovascular reactivity to psychological challenge: a laboratory model. Psychosom Med. 1990;52:42–58.[PubMed][Google Scholar]
  • 9. Kaslow NJ, Deering CG, Racusin GRDepressed children and their families. Clin Psychol Rev. 1994;14:39–59. doi: 10.1016/0272-7358(94)90047-7.[PubMed][Google Scholar]
  • 10. Bowlby J Attachment and Loss. London, England: Hogarth Press; 1973. [PubMed][Google Scholar]
  • 11. Gunnar MR, Nelson CAEvent-related potentials in year-old infants: relations with emotionality and cortisol. Child Dev. 1994;65:80–94. doi: 10.2307/1131367.] [[PubMed][Google Scholar]
  • 12. Oxman T E, Berkman LF, Kasl S, Freeman DH, Jr, Barrett JSocial support and depressive symptoms in the elderly. Am J Epidemiol. 1992;135:356–368.[PubMed][Google Scholar]
  • 13. Lee GRKinship and social support of the elderly: the case of the United States. Aging Soc. 1985;5:19–38. doi: 10.1017/S0144686X00011272.[PubMed][Google Scholar]
  • 14. Rook KSThe negative side of social interaction. J Pers Soc. Psychol. 1984;46:1097–1108. doi: 10.1037/0022-3514.46.5.1097.] [[PubMed][Google Scholar]
  • 15. Fabrigoule C, Letenneur L, Dartigues J, Zarrouk M, Commenges D, Barberger-Gateau PSocial and leisure activities and risk of dementia: a prospective longitudinal study. J Am Geriatr Soc. 1995;43:485–490.[PubMed][Google Scholar]
  • 16. Bassuk S, Glass T, Berkman LSocial disengagement and incident cognitive decline in community-dwelling elderly persons. Ann Intern Med. 1999;131:165–173.[PubMed][Google Scholar]
  • 17. Fratiglioni L, Wang H, Ericsson K, Maytan M, Winblad BThe influence of social network on the occurrence of dementia: a community-based longitudinal study. Lancet. 2000;355:1315–1315. doi: 10.1016/S0140-6736(00)02113-9.] [[PubMed][Google Scholar]
  • 18. Wethington E, McLeod JD, Kessler RC. The importance of life events for explaining sex differences in psychological distress. In: Barnett RC, Biener L, Baruch GK, editors. Gender and Stress. New York: The Free Press; 1987. pp. 144–156. [PubMed]
  • 19. Belle D. Gender differences in the social moderators of stress. In: Barnett RC, Biener L, Baruch GK, editors. Gender and Stress. New York: The Free Press; 1987. pp. 257–277. [PubMed]
  • 20. Belle D Lives in Stress: Women and Depression. Beverly Hills, CA: Sage; 1982. [PubMed][Google Scholar]
  • 21. Stroebe MS, Stroebe WWho suffers more? Sex differences in health risks of the widowed. Psychol Bull. 1983;93:279–301. doi: 10.1037/0033-2909.93.2.279.] [[PubMed][Google Scholar]
  • 22. Lowenthal MJ, Haven CInteraction and adaptation: intimacy as a critical variable. Am Sociol Rev. 1968;33:20–30. doi: 10.2307/2092237.] [[PubMed][Google Scholar]
  • 23. Belle DThe impact of poverty on social networks and supports. Marriage Fam Rev. 1983;5:89–103. doi: 10.1300/J002v05n04_06.[PubMed][Google Scholar]
  • 24. Dressler WW, Badger LWEpidemiology of depressive symptoms in black communities. J Nerv Ment Dis. 1985;173:212–220. doi: 10.1097/00005053-198504000-00002.] [[PubMed][Google Scholar]
  • 25. Corin E. The cultural frame: context and meaning in the construction of health. In: Amick BC III, Levine S, Tarlov AR, Chapman Walsh D, editors. Society and Health. New York: Oxford University Press; 1985. pp. 272–304. [PubMed]
  • 26. Boissevain J Friends of Friends. New York: St. Martin's Press; 1974. [PubMed][Google Scholar]
  • 27. Berkman LFThe role of social relations in health promotion. Psychosom Med. 1995;57:245–254.[PubMed][Google Scholar]
  • 28. Faris REL, Dunham HW Mental Disorders in Urban Areas. New York: Hafner; 1939. [PubMed][Google Scholar]
  • 29. Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith DSocial capital, income inequality, and mortality. Am J Public Health. 1997;87:1491–1498. doi: 10.2105/AJPH.87.9.1491.] [[Google Scholar]
  • 30. Kawachi I, Berkman LF. Social cohesion, social capital, and health. In: Berkman LF, Kawachi I, editors. Social Epidemiology. New York: Oxford University Press; 2000. pp. 174–190. [PubMed]
  • 31. Brown GW, Harris TO Social Origins of Depression: a Study of Psychiatric Disorder in Women. London: Tavistock; 1978. [PubMed][Google Scholar]
  • 32. Vachon M, Lyall W, Rogers JA controlled study of self-help intervention for widows. Am J Psychiatry. 1980;137:1380–1384.[PubMed][Google Scholar]
  • 33. Mittleman MS, Ferris SH, Shulman E, et al A comprehensive support program: effect on depression in spouse-caregivers of AD patients. Gerontologist. 1995;35:792–802.[PubMed][Google Scholar]
  • 34. Heller K, Thompson MG, Trueba PE, Hogg JR, Vlachos-Weber IPeer support telephone dyads for elderly women: was this the wrong intervention? Am J Community Psychol. 1991;93:53–74. doi: 10.1007/BF00942253.] [[PubMed][Google Scholar]
  • 35. Harris T, Brown GW, Robinson R. Befriending as an intervention for chronic depression among women in an inner city. I. Randomized controlled trial. Br J Psychiatry. 1999;174:219–224. doi: 10.1192/bjp.174.3.219.] [[PubMed]
  • 36. Brand EF, Lakey B, Berman SA preventive, psychoeducational approach to increase perceived social support. Am J Community Psychol. 1995;23:117–135. doi: 10.1007/BF02506925.] [[PubMed][Google Scholar]
  • 37. Cohen S, Gottlieb BH, Underwood LG. Social relationships and health. In: Cohen S, Underwood LG, Gottlieb BH, editors. Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000. pp. 3–25. [PubMed]
  • 38. Rook KS, Underwood LG. Social support measurement and interventions. Comments and future directions. In: Cohen S, Underwood LG, Gottlieb BH, editors. Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000. pp. 311–334. [PubMed]
  • 39. Gottlieb BH. Selecting and planning support interventions. In: Cohen S, Underwood LG, Gottlieb BH, editors. Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000. pp. 195–220. [PubMed]
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