A Short Social Support Measure for Patients Recovering From Myocardial Infarction

Mitchell, Pamela H.; Powell, Lynda H.; Blumenthal, James A.; Norten, J.; Ironson, Gail; Pitula, Carol Rogers; Froelicher, Erika Sivarajan; Czajkowski, Susan M.; Youngblood, Marston; Huber, Marc; Berkman, Lisa F.

doi:10.1097/00008483-200311000-00001

Cited by 489 publications

(421 citation statements)

References 14 publications

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“…The SCID 16 identified substance use disorder onset/ relapse within 3 years since study entry. Higher scores on the seven-item ENRICHD Social Support Instrument 19 (averaged over the first 5 years) indicated greater social support.…”

Section: Methodsmentioning

confidence: 99%

Relationship Between Spiritual Coping and Survival in Patients with HIV

2016

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BACKGROUND: Studies of spirituality in initially healthy people have shown a survival advantage, yet there are fewer research studies in the medically ill, despite the widespread use of spirituality/religiousness to cope with serious physical illness. In addition, many studies have used limited measures such as religious service attendance. OBJECTIVE: We aimed to examine if, independent of medication adherence, the use of spirituality/religiousness to cope with HIV predicts survival over 17 years. DESIGN: This was a longitudinal study, started in 1997. Study materials were administered semi annually. PARTICIPANTS: A diverse sample of 177 HIV patients initially in the mid-stage of disease (150-500 CD4-cells/ mm 3 ; no prior AIDS-defining symptoms) participated in the study. MAIN MEASURES: Participants were administered a battery of psychosocial questionnaires and a blood draw. They completed interviews and essays to assess current stressors. Spiritual coping (overall/strategies) was rated by qualitative content analysis of interviews regarding stress and coping with HIV, and essays. KEY RESULTS: Controlling for medical variables (baseline CD4/viral load) and demographics, Cox regression analyses showed that overall positive spiritual coping significantly predicted greater survival over 17 years (mortality HR = 0.56, p = 0.039). Findings held even after controlling for health behaviors (medication adherence, substance use) and social support. Particular spiritual coping strategies that predicted longer survival included spiritual practices (HR = 0.26, p < 0.001), spiritual reframing (HR = 0.27, p = 0.006), overcoming spiritual guilt (HR = 0.24, p < 0.001), spiritual gratitude (HR = 0.40, p = 0.002), and spiritual empowerment (HR = 0.52, p = 0.024), indicating that people using these strategies were 2-4 times more likely to survive. CONCLUSIONS: To our knowledge this is the first study showing a prospective relationship of spiritual coping in people who are medically ill with survival over such a long period of time, and also specifically identifies several strategies of spirituality that may be beneficial.

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Section: Methodsmentioning

confidence: 99%

Relationship Between Spiritual Coping and Survival in Patients with HIV

2016

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“…Social support was assessed using the seven-item Enhancing Recovery in Coronary Heart Disease Social Support Instrument, which assesses structural instrumental and emotional support (50), and optimism was measured using the LOT (51). We assessed cynical hostility with 10 items from the Cook Medley hostility scale and depressive symptoms with the Center for Epidemiologic Studies Depression Scale.…”

Section: Methodsmentioning

confidence: 99%

Shorter telomeres with high telomerase activity are associated with raised allostatic load and impoverished psychosocial resources

Zalli

Carvalho

Lin

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

162

118

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Recent work has linked psychological stress with premature cellular aging as indexed by reduced leukocyte telomere length. The combination of shorter telomeres with high telomerase activity (TA) may be indicative of active cell stress. We hypothesized that older individuals characterized by shorter telomeres with high TA in unstimulated leukocytes would show signs of high allostatic load and low levels of protective psychosocial resources. We studied 333 healthy men and women aged 54-76 y who underwent laboratory testing in which we measured cardiovascular, neuroendocrine, and inflammatory responses to standardized mental stress tasks. The tasks elicited prompt increases in blood pressure (BP), heart rate, cortisol, and mediators of inflammation and reductions in heart rate variability, returning toward baseline levels following stress. However, men having shorter telomeres with high TA showed blunted poststress recovery in systolic BP, heart rate variability, and monocyte chemoattractant protein-1, together with reduced responsivity in diastolic BP, heart rate, and cortisol, in comparison to men with longer telomeres or men with shorter telomeres and low TA. Shorter telomeres with high TA were also associated with reduced social support, lower optimism, higher hostility, and greater early life adversity. These effects were independent of age, socioeconomic status, and body mass index. We did not observe differences among older women. Our findings suggest that active cell stress is associated with impaired physiological stress responses and impoverished psychosocial resources, reflecting an integration of cellular, systemic, and psychological stress processes potentially relevant to health in older men. cellular senescence | allostasis | psychological distress T elomeres are nucleoprotein structures composed of tandem hexanucleotide repeats of the sequence TTAGGG that cap the ends of eukaryotic chromosomes, protecting them from end-to-end fusion and degradation during cell division. Human telomeric DNA naturally shortens with age during somatic cell divisions and as a result of oxidative attack (1, 2). At critical shortness, telomeres exhibit impaired function, leading to genomic instability, apoptosis, and cell senescence, often with altered transcriptional programming and mitochondrial dysfunction (1). Telomere attrition represents one of the hallmarks of aging (3). In humans, Mendelian singlegene mutations that directly compromise telomere maintenance cause premature mortality and onset of a spectrum of diseases overlapping with the age-related diseases common in the population (4). In addition, genome-wide association studies show that certain combinations of SNPs at genetic loci encoding known telomere-maintenance factors are associated with increased relative risks for pulmonary and coronary diseases (5). Shorter telomere length (TL) in white blood cells is linked and, in some cases, anticipates aging-related morbidity and mortality from conditions with immune system involvement, such as infectious disease...

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“…We also noted whether the participant was a caregiver for an elderly or disabled relative or friend. Participants rated their sense of control over their lives in general by using a six-point scale from 1 = very low to 6 = very high, whereas social support and optimism were assessed with standardized measures (37,38). The Cronbach α was satisfactory for all psychological measures (>0.75).…”

Section: Methodsmentioning

confidence: 99%

Disruption of multisystem responses to stress in type 2 diabetes: Investigating the dynamics of allostatic load

Steptoe

Hackett

Lazzarino

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

142

121

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Psychological stress-related processes are thought to contribute to the development and progression of type 2 diabetes, but the biological mechanisms involved are poorly understood. Here, we tested the notion that people with type 2 diabetes experience chronic allostatic load, manifest as dynamic disturbances in reactivity to and recovery from stress across multiple (cardiovascular, neuroendocrine, inflammatory, metabolic) biological systems, coupled with heightened experience of chronic life stress. We carried out an experimental comparison of 140 men and women aged 50-75 y with type 2 diabetes and 280 nondiabetic individuals matched on age, sex, and income. We monitored blood pressure (BP) and heart rate, salivary cortisol, plasma interleukin (IL)-6, and total cholesterol in response to standardized mental stress, and assessed salivary cortisol over the day. People with type 2 diabetes showed impaired poststress recovery in systolic and diastolic BP, heart rate and cholesterol, and blunted stress reactivity in systolic BP, cortisol, cholesterol, and IL-6. Cortisol and IL-6 concentrations were elevated, and cortisol measured over the day was higher in the type 2 diabetes group. Diabetic persons reported greater depressive and hostile symptoms and greater stress experience than did healthy controls. Type 2 diabetes is characterized by disruption of stress-related processes across multiple biological systems and increased exposure to life stress. Chronic allostatic load provides a unifying perspective with implications for etiology and patient management.ype 2 diabetes has a heterogeneous pathophysiology in which β-cell dysfunction and insulin resistance play pivotal roles (1). Stress-related factors may contribute to risk of type 2 diabetes through their impact on inflammatory, metabolic, cardiovascular, and neuroendocrine regulation (2). Socioeconomic adversity over the life course predicts type 2 diabetes in later life (3), whereas stress at work and more general indicators of perceived stress are associated with future diabetes (4, 5). There appears to be a bidirectional relationship between type 2 diabetes and depressive symptoms (6), and people with type 2 diabetes may report greater social isolation and more limited social support (7).These diverse associations between stress-related processes and diabetes are only partly accounted for by lifestyle factors such as physical inactivity, alcohol consumption, or adiposity, suggesting that direct psychobiological pathways may be involved. A helpful concept in this regard is allostatic load. Allostasis refers to the dynamic process of adaptation to environmental challenges through adjustments in multiple biological systems, including the hypothalamic-pituitary-adrenocortical (HPA) axis, autonomic nervous system, and metabolic and immune systems (8). Allostasis is essential for maintaining homeostasis, but repeated or sustained stimulation leads to allostatic load, the wear-and-tear that results from dysregulation of mediating processes. Allostatic load is freque...

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A Short Social Support Measure for Patients Recovering From Myocardial Infarction

Cited by 489 publications

References 14 publications

Relationship Between Spiritual Coping and Survival in Patients with HIV

Relationship Between Spiritual Coping and Survival in Patients with HIV

Shorter telomeres with high telomerase activity are associated with raised allostatic load and impoverished psychosocial resources

Disruption of multisystem responses to stress in type 2 diabetes: Investigating the dynamics of allostatic load

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