Nov 26 Flashcards
setup: meta-analysis of 148 studies assessing mortality as a function of social…
relationships
ie. having social support, marital status, integration of social networks
Ps from NA, Eu, Asia & Aus
Ps followed on average for 7.5 years
results: meta-analysis of 148 studies assessing mortality as a function of social…
average effect size OR odds ration = 1.50
50% increased likelihood of survival as a function of stronger social relationships
social relationships had HIGHER effect size on mortality than…
physical activity (controlling for adiposity)
drug treatment for hypertension
social relationships had EQUAL effect size to…
smoking cessation
results of social relationships x mortality meta-analysis HELD…
across age, sex, initial health status, follow-up period, and cause of death
many early epidemiological studies focused on what types of measures?
objective measures of social isolation
frequently operationalized being unmarried, living alone, infrequent contact with family & friends, not participating in organizations/clubs/religious groups
BUT being alone =/= feeling alone
loneliness
SUBJECTIVE feeling of social isolation
discrepancy between DESIRED and ACTUAL levels of social contact
social loneliness
dissatisfaction with SIZE of social network
emotional loneliness
lacking SUPPORT & AFFECTION
what type of loneliness is associated with poorer psychological health?
emotional loneliness
(rather than social loneliness)
associated with MDD, GAD
what suggests that the two constructs of loneliness are dissociable?
(social and emotional loneliness)
results that emotional loneliness alone is linked to MDD and GAD
loneliness is linked to what?
- increased ALL CAUSE MORTALITY risk
- negative PHYSICAL HEALTH outcomes
a) coronary heart disease & stroke
b) cognitive decline & dementia
c) decreased immunity
loneliness & cold symptoms study setup
experimental study
- healthy Ps completed measures of:
a) loneliness
b) objective social isolation (social network size)
- administered nasal drops containing a common cold virus, and quarantined for 5 days
loneliness & cold symptoms results
loneliness (but not objective social isolation) predicted greater cold symptoms
marital quality & health outcomes
low marital quality is linked to heightened mortality risk & negative health outcomes
- worse SELF RATED health
- CARDIOVASCULAR disease and METABOLIC SYNDROME
^ cluster of CVD risk factors - high BP, insulin resistance
- PEPTIC ULCERS
- SLOWER RECOVERY post-surgery
social control hypothesis
interactions with family and friends motivate healthier behaviours
ie. being married associated with engaging in health-promoting behaviours like exercise whereas loneliness predicts physical inactivity
BUT associations between relationships and health persist even when controlling for (un)healthy behaviours
when dealing with social stressors/lacking social support, may rely on…
unhealthy coping strategies
ie. drinking, drug use
association between relationships & health persists even…
when controlling for (un)healthy behaviours
2 models of social support
- stress buffering model
- main effects model
stress buffering model
close relationships PROTECT health by buffering (mitigating) the effects of external stressors
ie. perceived support & hugs received over 2 weeks before virus exposure buffers against rise in infection risk associated with interpersonal conflict
main effects model
close relationships exert DIRECT effect on health outcomes regardless of levels of external stress
are both models of social support likely to play a role in associated between relationships and health?
yes
physiological mechanisms behind link between social support and health
presence or absence of positive social connection may DIRECTLY tap into the PHYSIOLOGICAL SYSTEMS that shape health and disease
- ANS
- HPA axis
- immune system
^ these systems help maintain body’s HOMEOSTATIC BALANCE in the face of internal/external challenges (stressors)
what do the ANS, HPA axis and immune system do, on a broad level?
help maintain body’s HOMEOSTATIC BALANCE
in face of internal/external challenges (stressors)
stressor
anything that knocks (or threatens to knock) homeostasis out of balance
ANS
division of the NS that carries INVOLUNTARY COMMANDS to your:
a) organs
b) blood vessels
c) glands
2 branches of the ANS
- sympathetic NS
^ energy mobilization, “fight or flight”
- parasympathetic NS
^ energy conservation, “rest and digest”
HPA axis
cascade of events that culminates in release of hormone CORTISOL from adrenal glands
^ mobilizes GLUCOSE reserves for energy
^ increases CONVERSION of proteins/fats
^ increases BLOOD PRESSURE ensuring adequate blood flow
immune system
DETECTS and ELIMINATES harmful invaders like bacterial/viral pathogens
also detects/responds to TISSUE DAMAGE
highly complex, several components
2 important components of the immune system
- INFLAMMATORY: rapid, NONSPECIFIC immune defence against infection and tissue damage
- ANTIVIRAL: more specific response tailored to viruses
inflammatory response
orchestrated by chemical messengers called PRO-INFLAMMATORY CYTOKINES
trigger set of PHYSIOLOGICAL and BEHAVIOURAL changes
physiological changes set off by inflammatory response
increasing blood flow to infected tissues
increasing blood vessel permeability
behavioural changes set off by inflammatory response
behavioural changes that promote survival and recovery
^ SICKNESS BEHAVIOURS
sleepiness, lethargy, withdrawal, reduction in various kinds of activity (exploration, social, sexual)
sickness behaviours help by CONSERVING ENERGY
may also reduce risk of PREDATION/ATTACK while vulnerable
why might social factors like loneliness or connection influence systems designed to deal with physical threats? (immune system)
responses to challenges are PROACTIVE, not simply reactive - they ANTICIPATE/PREPARE for potential threats
^ earlier response facilitates adaptive coping
IMMUNE SYSTEM TALKS TO THE BRAIN TO GATHER INFO ABOUT ENVIRONMENTAL CONDITIONS & EXPECTED THREATS
social disconnect poses risk to…
survival
increased risk of predation, wounding, infection
^ so if social connection is ended, bodies may mount pre-empted stress response
may response by up-regulating pro-inflammatory activity
social disconnection = up-regulation of what and down-regulation of what?
up-regulation of pro-inflammatory activity
down-regulation of anti-rival response
among older adults, both objective social isolation and feelings of loneliness predict…
- higher levels of pro-inflammatory activity
- decreased anti-viral response
examples of social stressors being linked to greater inflammation
- CHILDREN (<8 years old) exposed to social stressors (parental separation, abuse) show elevated markers of inflammation 2 and 7 years later
- ADOLESCENTS who report having more negative social interactions with friends and family (ie. rejection) showed higher levels of inflammatory activity
- COLLEGE students who reported experiencing more negative/competitive social interactions on daily basis showed higher levels of inflammation
- OLDER adults who recently lost a spouse had 1.5 x levels of inflammatory activity than controls
other markers of physiological stress that feelings of loneliness are related to
elevated cortisol
increased BP
lab social stressor test
Trier Social Stress Test (TSST)
Trier Social Stress Test (TSST)
combines elements of UNCONTROLLABILITY and SOCIAL EVALUATION
situation where you can be negatively judged by others
Ps who completed TSST in front of an evaluative panel…
(versus a control non-social evaluative condition)
- showed LARGER INCREASES pre- and post-test in…
a) cortisol
b) pro-inflammatory activity
- showed DECREASED SENSITIVITY to…
a) suppressive effects of glucocorticoids
what happened to sensitivity to _________ in TSST evaluative panel condition?
sensitivity to glucocorticoids decreased