Social Connectedness and Health

Question 1

The policy context of social connectedness and its relationship

Answer 1

to help and the way that we can
see the gradual consolidation of a focus on connectedness as an important psychosocial issue for health and well-being.

When psychologists practise family therapy or they practise systemic therapy, they’re conceptualising problems in terms of where they sit within a system of relationships.

Idea that social relationships are important for well-being is not new.

Question 2

Graham drawing

Answer 2

Therapists begin the process of assessment and formulation by making Agena

· Idea that an absence of social connectedness might be a problem is now a political issue was first introduced in the U.K.
· Sort of a policy matter with the launch of a national loneliness strategy.
 
· More evidence about the relationship between loneliness and specific mental health problems, loneliness, and loss of functioning in in old age, loneliness and vulnerability to mental health problems in young people.
· Social and Physical distance thing in response to the pandemic.
· And those that those strategies have created additional worries about social isolation and loneliness, so this link between social relationships and health

Question 3

Evidence
Abstract from prestigious journal in Science in 1988 by James House

Answer 3

• Particularly prospective studies and experimental studies that suggest an increased risk of death amongst persons with low quality and sometimes low quality of social relationships and them.· And also that separating humans, animals out from their peers appeared to be a major risk for mortality in more controlled settings· Mechanisms through which social relationships affect health and the factors that promote or inhibit the development and maintenance of social relationships remain to be explored.

Question 4

Paper by Roy Baumeister and Mark Leary

Answer 4

Carry out review

• Meandering theoretical review which allows them to make links to key psychological concepts.
• Connected to this idea of the importance of belonging to things like attachment, group membership, cognition, emotion.
• And they do that in the service of an argument (fundamental of being a human)
• To have and seek interpersonal attachments and connexions to feel you, you belong, and you connect with others.
• Idea of there being something absolutely foundational about belonging and connexion is sort of underlined here

Question 5

Examining the relationship between social relationships?

Answer 5

Sort of fragmentation.
A systematic review

· Individual studies which examine the relationship between social relationships,
social connectedness, or the flip side, disconnection. Loneliness, health, Wellbeing and Mortality. 
Fragmented literature which allows us to see the distinct issues for older people,
· Risk of depression increasingly well evidenced in growing mental health literature 
· Risk might be about the development, development of social anxiety or or psychotic experiences.
· A split in the literature in terms of the way that social connexions are configured

Question 6

Paper containing a large metro analysis by Julian, Holte, Lundestad and colleagues

The Cross 148 studies:

Answer 6

· 50% increased likelihood of survival for participants with stronger social relationships.

· Studies across a range of age groups, range of health related groups with a range of different study characteristics.
 
· Finding that the increased mortality risk is pretty significant across all these contexts.
 
· Focuses on the mind from a political point of view and invites to think about actually and what are we going to do about these four different populations with different kinds of health risks?

Question 7

Paper containing a large metro analysis by Julian, Holte, Lundestad and colleagues

The Cross 148 studies: Cons

Answer 7

• How are we going to mitigate against the loss of either good quality social
• relationships or the loss of an appropriate quantity of social relationships?
• How do we protect people against loneliness and social isolation?

What do we mean by these concepts and what we know about how they connect with the idea of social identity and social capital?

Question 8

How social connectedness has become an important part of the policy arena through its association with health outcomes and mortality…

Answer 8

· These concepts are helpful when it comes to understanding how social relationships might have an impact on our health and well-being.

· Social capital--à one's ability to draw upon social resources within one's community, through one's relationship to others.

For example, If you can mobilise those resources and if you’re linked into lots of different groups and organisations and people in relationships, you’ve got lots more opportunities to do things and lots more pathways to get things done.

A link to economic capital
if you’ve got the financial resources to buy your travel ticket,
as well as to the social resources to know who to ask about, where the bus goes from, for example, they fit together.

Question 9

Evaluation of How social connectedness has become an important part of the policy arena through its association with health outcomes and mortality…

Answer 9

But it’s one form of capital which is distributed unequally.

Question 10

Quote to where the concepts comes from

Answer 10

• it comes from this systematic review.
• The Opeth one.
• Concept of social capital comes from you
• Emphasises the way that social capital reproduces inequalities because it allows some people to mobilise the capital of their families or the clubs they belonged to or the schools they went to or other kinds of groups and organisations that they might belong to.
• Argues that social capital creates barriers for some groups or some individuals.
• Allows or facilitates others to progress and achieve various kinds of social outcomes.
• Creates a disparity for different individuals and groups of individuals.

Question 11

Ways in which social capital allows us to do things

Answer 11

· Permits us to do things. 11:43
· Also a psychological aspect to social capital.
· So what they say in their review is that across the literature,
· It looks like it’s more to do with the individual’s ability to build reciprocal relationships than it is to do with the differences between the different communities that individuals might be in.

Question 12

So is this suggesting that there’s something about our psychosocial capacity for building
and developing and utilising reciprocal relationships that then affects our outcomes here?

Answer 12

Investing in interventions and policies that will help people to get better at that.

· One thing that farmers get, that one thing that our previous government did was sure start.
 
· So in the early 90s and early 2000s,

UK government scheme called Sure Start and invested a lot of money in children’s centres, in communities across the country.

Attempt to increase the social capital of parents from more marginalised and vulnerable
communities with a view to improving the health and wellbeing outcomes of their new children.

• suggested that they were spending more than they were recouping in benefits by 2010,
• Beginning to show direct benefits to the home environments of five year olds and their families.
• Takes a while for families to start to be showing improvements.

Question 13

2019- the programme had largely been cancelled by the government that had followed a very large financial evaluation and suggested that the sure START scheme

Answer 13

• saved the U.K. economy millions of pounds in terms of costs to NHS care through the changing behaviour of these these families.
• children from that cohort were much less likely to find themselves in an emergency with injuries or with childhood ailments that didn’t need to be accident and emergency,

For example, so that the health literacy in those families had improved, but also the home environment had improved —à fewer injuries and illnesses for children.

· Investment there in a kind of ability to navigate the community, to navigate health care relationships, to understand one's role as a parent and to manage those kinds of things, 
· Over a period of 15 to 20 years, started to pay off really substantial dividends.
 
· Slow and difficult to have an impact on these kinds of variables especially when intervening at the at the early end.
 
· There are long term effects but you have to be patient when it comes to this.

Question 14

Introduction to a special edition of the Journal of Applied Psychology

Answer 14

· About social identity and health.
· Social identity model is saying that group membership impacts on our individual psychology because we internalise that group membership as part of our identity.

· And if groups provide us with a sense of meaning and purpose and belonging, then they tend to have positive psychological consequences for us.

High Mood High Esteem

Question 15

What do we mean by connectedness?

Answer 15

· How policymakers are thinking about loneliness.

Psychologists started tackling this by thinking about the presence of something.

· What are the benefits, that social connexion, this got turned into a deficit.

· So now policymakers are thinking about what the costs of loneliness are, which is the reverse.

It comes from the government’s strategy for tackling loneliness.

· It draws upon a important series of papers by Peplow and Pohlman, which are to do with understanding and defining loneliness.
· Those same government resources also provide Peplow and Pearlman's definition.
 
· And so you can see there are some underlying factors associated with loneliness here, social and cultural influences, identity and personality.

Question 16

Example life events connectedness?

Answer 16

might make you feel more or less lonely, depending on how well equipped you are to deal with them.
There’s some psychological stuff to do with such as thinking style

People tend to see it as something you can control or something that you can tolerate—à And so all of those things interacting with one another may or may not produce an experience of loneliness in a given situation.

· So that's not the exact opposite of the experience of connectedness,
· The presence and role of other people is not as present here.
·  
· Loneliness--> That happens when we have a mismatch between the quantity and quality of the social relationships that we have and those that we want.

So the mismatch is between what we have and what we want. And it can take the form of being a mismatch in terms of quantity.

· So it includes the possibility of thinking about social isolation, which has to do with the quantity of social relationships, as well as loneliness, which is more conventionally to do with the quality or meaning of those relationships.

Question 17

Policy documents

Answer 17

Like to sharpen that distinction.
For example:

· This is from the Local Government Association's report on loneliness, where they want to make the distinction that social isolation is an objective state

1. could look at the number of social contacts in someone’s life by doing a social network analysis,
   · for example, and you could decide that they are objectively isolated.
   · It may not feel lonely. They may enjoy solitude.
2. But you could still be concerned about the lack of social contact that is available to them as an objective issue.
   · Whereas loneliness is generally seen as a subjective appraisal, regardless of how many contacts you have, you may still feel lonely.
   · Many of us will have had the experience of being in a crowded room and feel feeling apart and lonely.
   3. And there are some good Internet means that could capture that very nicely.

Question 18

My explanation of Social connectedness

Answer 18

On the one hand, we’ve got some ideas that have to do with the quality of the connexions that we have and who we connect with.
So there are people that we would hope to be close to comfortable with family, partners, friends, perhaps some colleagues.

These are the sort of the good quality relationships that we would hope to have.

Also there is something to do also with the quantity of Connexions that the amount of contact that we have.

There’s the where you belong and where do you fit in, what’s the context of your connexions and contacts?

Partly where Social capital fits in and partly where social identity comes into.

Question 19

What groups do you belong and what positive associations can you draw on with those things?

Answer 19

Areas where possible to intervene:

So sure, START - Intervention,
AIM- trying to improve the quality of people’s connexions and is trying to do that by improving their ability to have relationships really early on in life.

By improving people’s experiences of some of their early years experiences, then you would hope they have got better attachments, that they’ve got better emotional literacy,

• come to develop relationships which are more durable and more supportive to them across the lifespan.
• Early years version of intervention, which is maybe to do with how you strengthen people’s ability to have good relationships.
• Mitigating sort of intervention that you might do, which is to do with improving the quantity of connexions in people’s lives and improving people’s social capital and their opportunities to develop important social identities.

does include a similar way of thinking about both the quality and quantity of connexions that are available to people.

Question 20

What are the mechanisms through which social relationships may affect health?

Answer 20

Our mood and emotional state

• State of high arousal all the time because we’re anxious or if we’re in a state of low motivation because we’re depressed,
• Our mood and the violence of our mood is very negative and low, then those will affect our ability to do things and achieve things.
• Knock on by a psychosocial effects on our on our health.
• Our identity is important effects our social esteem and ability to participate
• The extent to which we feel vulnerable to stigma and other kinds of negative social judgement may affect our ability to draw on social resources,
  Example: Pine’s social events
• Cognitions that we engage in as a consequence of these mood and identity issues are also likely to be important.
• More or less inclined to take risks depending on our mood and the extent to which we feel we are supported by other people.
  Example: Might be more able to pursue help seeking if we have social capital, we might be better at problem solving in ways that are beneficial for our health.

Question 21

Factors that might promote or inhibit the developments and maintenance of social relationships : 1

Answer 21

1. Traits and state preferences
   - to do with what people feel more or less comfortable with and more or less capable of dealing with in terms of the amounts of contact that they have with others and the nature of that contact.
   - structure our social world in ways that allows people to flourish,
   - regardless of those state and trade preferences, is important.

Question 22

Factors that might promote or inhibit the developments and maintenance of social relationships : 2

Answer 22

1. Thinking about how some people are arousal seeking and and playful and other people are quiet and like to understand what to expect
   - create very different sorts of requirements for developing supportive, reciprocal relationships.
   - issue of our prior experience
   - Opportunity to learn how to regulate and tolerate our emotions and to and to tolerate the emotions of other people?
   - Learnt how to understand other people’s perspectives and what their emotions might be like for them?
   - Developed a style of attachment and an understanding of how relationships work
   - Allow us to navigate and manage different kinds of relationships in our lives?
   - Important developmental processes as everybody’s outcomes and styles are different

The general developmental process allows us to function in ways that are suitable for our different states and traits.

Question 23

Factors that might promote or inhibit the developments and maintenance of social relationships : 3

Answer 23

3. Opportunity and social capital
   - vary across different communities, families and situations.

Question 24

Factors that might promote or inhibit the developments and maintenance of social relationships : 4

Answer 24

4. Identity and group membership

Interacting with all of these more psychological and social factors to shape what’s possible for us and to and to create some barriers for us and some facilitators for us.

Question 25

Where can we intervene? Children

Answer 25

can intervene through earlier services and also the Social Security safety net
· Important that parents are able to meet their children’s basic needs.
· Important that we have services which scaffold supportive parenting,

—-> reduce children’s exposure to early life trauma and which intervene early in any sort of emerging social anxiety that might occur during the school year so that we create conditions where children thrive —> able to develop healthy attachments, and where they grow into adults who can manage their relationships and who can participate in social groups on terms which are acceptable and helpful and meaningful to them.

Question 26

Where can we intervene? Adult

Answer 26

· Schools–> providing education and experiences around relational literacy.

—> In adulthood doing it by healthcare services so we can do that by providing social skills training or psychological interventions for things like depression and social anxiety-à mean that people get locked into rather avoidance cycles with their social relationships.

· Social care and community services–> peer support, social prescribing, a Social Security, safety net, community resources and activities,

· Libraries and youth groups–> give people opportunity to develop different kinds of connexions to other people and knowledge about other people.

Question 27

Systematic review of interventions to reduce loneliness in people with mental health problems

Answer 27

Pyramid representation of these different levels of intervention:
· At the psychological level, you can intervene therapeutically and with different kinds of training and support with people who are lonely.
· At the community level, you can intervene with group activities that are directed at families or at or through mental health services or other kind of primary care or voluntary organisations.
· Social prescribing has become quite a popular idea.
Social prescribing–> idea that you might help people to develop their social capital and strengthen their support network by helping them to get involved in group activities
Example: like maybe joining a gardening group or a walking group or something like that.

Services should be able to do is to link better with things that are going on in their local community.
- to help people who might benefit from joining those groups to sort of broach the boundaries of those groups.
- local government can think about how they invest in in these kinds of broader environmental outcomes.

Question 28

Authors in this paper supporting interventions to reduce loneliness in people with mental health problems

Answer 28

• they provide a kind of typology of interventions.
• Attempts to change cognitions, which are largely done at the individual level, their attempts to provide social skills training or psycho education.
• Attempts to support social socialisation by having a socially focussed supporter.
• Attempts to develop more collaborative, porous community resources that people can can use at community level.

Question 29

Kind of early years of the picture has disappeared….

Answer 29

• When people talk, talk about loneliness, they tend to start to think of the problem as a problem that’s already present in adulthood.
  5. Requires a Immediate solution.
  6. Other people see that as more of a long term investment where you might need to invest in people’s lives early on through effectively prevention-> no need to provide these services and interventions to scaffold adults against loneliness because they’ll have
  
  7. the skills and the support networks that they have developed through there through their adolescence and early adulthood by the time they are adults