Social Support and Social Undermining as Correlates for Alcohol, Drug, and Mental Disorders in American Indian Women Presenting for Primary Care at an Indian Health Service Hospital

Abstract

The purpose of this study was to determine the relationship of two types of social support (emotional and instrumental) and two types of social undermining (critical appraisal and isolation) with five categories of alcohol, drug, or mental disorders (ADM; any mood, any anxiety, any substance abuse, any disorder, and two or more disorders) in 169 American Indian women presenting for primary care at an Indian Health Service facility. Social support and social undermining are often treated as opposite poles, but in fact they are distinct factors with independent effects. The findings illustrate that social support and undermining variables have a significant relationship with ADM outcomes even when controlling for confounding demographic variables. Any substance abuse was associated with all four social variables, while two or more disorders were associated with instrumental support and isolation. Any anxiety (isolation), any mood (critical appraisal), and any disorder (isolation) were each associated with one social variable. Overall, social undermining appears to have a stronger relationship with mental health than with social support.

Social Support and Social Undermining as Explanatory Factors for Health-Related Quality of Life in People Living With HIV/AIDS

“…The operationalization of emotional support in this study includes provision of love, affirmation, and caring, whereas instrumental support contains tangible aid. This choice is consistent with prior research examining health outcomes (e.g., Oetzel, Duran, Jiang, & Lucero, 2007). We also considered two types of social support from health care providers: information and emotional support (Galassi, Schanberg, & Ware, 1992).…”

“…direct effects for undermining (e.g., Jia et al, 2005;Oetzel et al, 2007). For example, in a cross-sectional survey of 86 participants living with HIV, Viswanathan and colleagues (2005) found that social support was positively related to the physical component summary of the MOS-HIV in a model that considered demographics, CD4 cell count, and medication adherence.…”

Factors of interpersonal communication and behavioral health on medication self-efficacy and medication adherence

“…Social support and undermining were measured with a modified version of a previously validated social support and undermining scale (Oetzel et al, 2007). There are 20 items measured on a five-point scale (5 = strongly agree).…”

“…In contrast to social support, PLWH's experiences of negative interpersonal interactions, also known as social undermining (Finch, 1998;Fleishman et al, 2000;Oetzel, Duran, Jiang, & Lucero, 2007;Oetzel et al, 2014), have received limited scholarly attention. Social undermining negatively impacts behavioral health, including drug and mood disorders (e.g., Axelrod, Myers, Durvasula, Wyatt, & Cheng, 1999;Finch, 1998;Oetzel et al, 2007).…”

“…Social undermining negatively impacts behavioral health, including drug and mood disorders (e.g., Axelrod, Myers, Durvasula, Wyatt, & Cheng, 1999;Finch, 1998;Oetzel et al, 2007). The construct might be related to stigma, which has been shown to negatively affect medication adherence among PLWH (DiMatteo, Lepper, & Croghan, 2000;Goldsmith, Brashers, Kosenko, & O'Keefe, 2008).…”