Lecture 24: Social Support

Question 1

social relationships & mortality risk

Answer 1

• Meta-analysis of 148 studies assessing mortality as a function of social relationships
  Participants from North America, Europe, Asia, and Australia
• Participants were followed on average for 7.5 years
• Average effect size = 1.50
• 50% increased likelihood of survival as a function of stronger social relationships
• Results held up across age, sex, initial health status, follow-up period, and cause of death

Question 2

objective vs. subjective isolation

Answer 2

• Many early epidemiological studies focused on objective measures of social isolation
• Frequently operationalized as being unmarried, living alone, infrequent contact with family & friends, not participating in organizations/clubs/religious groups
• Being alone isn’t the same as feeling alone

Question 3

loneliness

Answer 3

• The subjective feeling of social isolation
• Discrepancy between desired and actual levels of social contact

Question 4

social loneliness

Answer 4

dissatisfaction with the size of one’s social network

Question 5

emotional loneliness

Answer 5

lacking support & affection

Question 6

loneliness & health outcomes

Answer 6

• Emotional, rather than social loneliness, is associated with poorer psychological health (MDD, GAD)
• Suggests that two constructs are dissociable, yet not always distinguished in the research
• Loneliness is linked to increased all-cause mortality risk & negative physical health outcomes, like coronary heart disease and stroke, cognitive decline and dementia, decreased immunity

Question 7

loneliness & cold symptoms study design

Answer 7

• Healthy participants completed measures of loneliness and objective social isolation (social network size)
• Administered nasal drops containing a common cold virus and quarantined them for 5 days

Question 8

loneliness & cold symptoms study findings

Answer 8

Loneliness, but not objective social isolation predicted greater cold symptoms

Question 9

marital quality & health outcomes

Answer 9

• Low marital quality is linked to heigheted risk of mortality & negative health outcomes:
• Worse self-rated health
• Cardiovascular disease & metabolic syndrome
• Peptic ulcers
• Slower recovery post-surgery

Question 10

social control hypothesis

Answer 10

• Interactions with family & friends motivate healthier behaviours
• Ex. being married is associated with engaging in health-promoting behaviours like exercise, whereas loneliness predicts physical inactivity

Question 11

health behaviours and singlehood

Answer 11

• May rely on unhealthy coping strategies when dealing with social stressors or lacking social support
• But, the association between relationships & health persists even when controlling for (un)healthy behaviours

Question 12

two models of social support

Answer 12

stress buffering model & main effects model

Question 13

stress buffering models

Answer 13

• Close relationships protect health by buffering (mitigating) the effects of external stressors
• Ex. perceived support & hugs received over 2 weeks before virus exposure buffers against rise in infection risk associated with interpersonal conflict

Question 14

main effects model

Answer 14

• Close relationships exert direct effects on health outcomes regardless of levels of external stress
• Both likely play a role in the association between relationships and health

Question 15

physiological mechanisms

Answer 15

• The presence or absence of positive social connection may directly tap into and physiological systems that shape health & disease
• Autonomic nervous system
• Hypothalamic-pituitary-adrenal (HPA) axis
• Immune system
• Broadly, these systems help maintain the body’s homeostatic balance in the face of internal and external challenges

Question 16

stressor

Answer 16

anything that knocks (or threatens to knock) homeostasis out of balance

Question 17

autonomic nervous system

Answer 17

Division of the nervous system that carries involuntary commands to your organs, blood vessels, and glands

Question 18

two components of the autonomic nervous system

Answer 18

sympathetic & parasympathetic nervous systems

Question 19

sympathetic nervous system

Answer 19

energy mobilization, “fight or flight” response

Question 20

parasympathetic nervous system

Answer 20

energy conservation, “rest and digest” response

Question 21

hypothalamic-pituitary-adrenal (HPA) axis

Answer 21

• Cascade of events that culminates in the release of the hormone cortisol from adrenal glands
• Mobilizes glucose reserves for energy, increases conversion of proteins and fats
• Increases blood pressure, ensuring adequate blood flow

Question 22

immune system

Answer 22

• Detects and eliminates harmful invaders such as bacterial or viral pathogens
• Also detects and responds to tissue damage
• Highly complex, several components, including
• Inflammatory response: rapid, nonspecific immune defence against infection & tissue repair
• Antiviral response: more specific response tailored to viruses

Question 23

inflammatory response

Answer 23

• Orchestrated by chemical messengers called proinflammatory cytokines
• Set of physiological changes (ex. Increasing blood flow to infected tissue, increasing blood vessel permeability)
• Also trigger a set of behavioural changes that help promote survival & recovery (sickness behaviours)
• Sleepiness, lethargy, withdrawal, reduction in various kinds of activity (exploration, social, sexual)
• Sickness behaviours help by conserving energy, may also reduce the risk of predation/attack while vulnerable

Question 24

health implications of social support

Answer 24

• When functioning optimally, these systems facilitate adaptive coping with threats and maintain health, but with sustained activation may begin to see dysregulation leading to disease
• Feedback mechanisms become impaired
• Cortisol normally inhibits inflammation but prolonged exposure to cortisol and pro-inflammatory cytokines may increase glucocorticoid resistance of immune cells, leading to chronic inflammation
• Chronic inflammation implicated in development of cancer, heart disease, diabetes, neurodegenerative disorder, and depression
• Chronic activation of the sympathetic system can lead to the buildup of plaque on arterial walls -> increased risk of a heart attack

Question 25

brain-immune system connection

Answer 25

• Social disconnection poses a risk to survival (increased riks of predation, wounding, infection)
• May respond by upregulating proinflammatory activity
• At the same time, it decreases the risk of a viral infection
• Downregulation of antiviral response
• Among older adults, both objective social isolation and feelings of loneliness predict higher levels of proinflammatory activity coupled with decreased antiviral response

Question 26

real world social stressors and inflammation

Answer 26

• Across the lifespan, social stressors have been linked to greater inflammation
• Children < 8 years old exposed to social stressors show elevated markers of inflammation 2 and 7 years later
• Adolescents who report having more negative social interactions with friends & family showed higher levels of inflammatory activity
• College students who reported experiencing more negative and competitive social itneractions on a daily basis showed higher levels of inflammation
• Older adults who recently lost a spouse had 1.5 x levels of inflammatory activity than controls

Question 27

Trier Social Stress Test (TTST)

Answer 27

combines elements of uncontrollability and social evaluation (situation where the self could be negatively judged by others)

Question 28

TTST studies

Answer 28

• Participants who completed the TTST in front of an evaluative panel (vs. a control non-social evaluative condition) showed a larger increase in cortisol and proinflammatory activity from pre- to post-stress
• Immune cells of participants from the social evaluative condition showed decreased sensitivity to suppressive effects of glucocorticoids
• Participants who show more social pain-related neural reactivity to social exclusion showed larger increases in inflammation following TTST
• Other studies have evaluated effects of conflict discussion in couples
  Increase in systemic inflammation following conflict discussion in high- but not low-hostility couples

Question 29

stress buffering

Answer 29

• Current experiences and history of social support affect the magnitude of physiological responses to stressors
• Ex. preparing with romantic partner or receiving written supportive messages from partners buffer cortisol response to the TTST
• Anxiously & avoidantly attached individuals show stronger cortisol responses during lab stressors

Question 30

cognitive mechanisms: stress appraisals

Answer 30

• Social factors may impact the way we think about potential stressors, which in turn influences the stress response
• Cognition plays a role in triggering, amplifying, and reducing stress responses
• Most reactive to stressors when we perceive them as uncontrollable & exceeding our coping capabilities
• Through history of positive interactions with caregivers, securely attached individuals learn that stressors are manageable, that they are capable, and that others can be relied on

Question 31

cognitive mechanisms: threat detection

Answer 31

• Current and former social conditions influence social threat detection
• Loneliness is associated with heightened threat vigilance
• Ex. in modified emotional Stroop task, lonely participants, relative to non lonely participants, showed greater Stroop interference specifically for negative social relative to negative nonsocial words
• Anxiously attached individuals exhibit readiness to perceive threat & have high access to threat-related cognitions, even in positive contexts
• Ex. exhibit higher levels of cortisol and lower levels of heart rate variability (measure of PNS activation) when asked to imagine being cared for by another person

Question 32

sensitivity to threat & reward

Answer 32

• Experimental inflammatory challenge: administration of bacterial toxin (endotoxin) that triggers an immune response
• Increases in depressed mood, feelings of social disconnect & sensitivity, and loneliness
• Greater neural reactivity in pain- and threat-related brain in response to negative social evaluation & threatening social faces
• Larger increases in proinflammatory in cytokines -> greater neural reactivity
• But, there is also increased neural reactivity in reward-related brain regions (ex. Ventral striatum) in response to social rewards but not non-social rewards
• Also a greater desire to be with close others