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      The moderating role of social network size in the temporal association between formal social participation and mental health: a longitudinal analysis using two consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE)

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          Abstract

          Introduction

          Previous studies have shown that engaging in formal social participation may protect against declining mental health, but social network size (the number of close social ties a person has) may moderate the relationship. We assessed the potential moderating role of social network size using longitudinal data.

          Methods

          Nationally representative data from two consecutive waves (2011, 2013) of the SHARE survey were analyzed. The data consisted of 38,300 adults from 13 European countries aged 50 years and older in 2011. Measures pertaining to formal social participation, social network size, quality of life, and depression symptoms were used. Multivariable linear regression models were conducted.

          Results

          The majority of participants (over 70% of the sample) had a social network size of four or less close social ties. We identified significant moderations in both models. Individuals with relatively few close social ties may have benefitted from formal social participation both in terms of reductions in depression symptoms and increases in quality of life, while formal social participation among those with many social ties did not appear to be beneficial, and may even to some extent have been detrimental.

          Conclusions

          Declines in mental health specifically among those with relatively few close social ties could potentially be prevented through the promotion of formal social participation. It is possible that such strategies could have a greater impact by specifically targeting individuals that are otherwise socially isolated. High levels of formal participation among those with relatively many close social ties may not be pragmatically beneficial.

          Electronic supplementary material

          The online version of this article (10.1007/s00127-020-01961-2) contains supplementary material, which is available to authorized users.

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          Most cited references55

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          Mechanisms linking social ties and support to physical and mental health.

          Over the past 30 years investigators have called repeatedly for research on the mechanisms through which social relationships and social support improve physical and psychological well-being, both directly and as stress buffers. I describe seven possible mechanisms: social influence/social comparison, social control, role-based purpose and meaning (mattering), self-esteem, sense of control, belonging and companionship, and perceived support availability. Stress-buffering processes also involve these mechanisms. I argue that there are two broad types of support, emotional sustenance and active coping assistance, and two broad categories of supporters, significant others and experientially similar others, who specialize in supplying different types of support to distressed individuals. Emotionally sustaining behaviors and instrumental aid from significant others and empathy, active coping assistance, and role modeling from similar others should be most efficacious in alleviating the physical and emotional impacts of stressors.
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            Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis

            Research indicates that social isolation and loneliness increase the risk of mental disorders, but less is known about the distinct contributions of different aspects of isolation. We aimed to distinguish the pathways through which social disconnectedness (eg, small social network, infrequent social interaction) and perceptions of social isolation (eg, loneliness, perceived lack of support) contribute to anxiety and depression symptom severity in community-residing older adults aged 57-85 years at baseline.
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              No health without mental health.

              About 14% of the global burden of disease has been attributed to neuropsychiatric disorders, mostly due to the chronically disabling nature of depression and other common mental disorders, alcohol-use and substance-use disorders, and psychoses. Such estimates have drawn attention to the importance of mental disorders for public health. However, because they stress the separate contributions of mental and physical disorders to disability and mortality, they might have entrenched the alienation of mental health from mainstream efforts to improve health and reduce poverty. The burden of mental disorders is likely to have been underestimated because of inadequate appreciation of the connectedness between mental illness and other health conditions. Because these interactions are protean, there can be no health without mental health. Mental disorders increase risk for communicable and non-communicable diseases, and contribute to unintentional and intentional injury. Conversely, many health conditions increase the risk for mental disorder, and comorbidity complicates help-seeking, diagnosis, and treatment, and influences prognosis. Health services are not provided equitably to people with mental disorders, and the quality of care for both mental and physical health conditions for these people could be improved. We need to develop and evaluate psychosocial interventions that can be integrated into management of communicable and non-communicable diseases. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of HIV, tuberculosis, and malaria; gender-based violence; antenatal care; integrated management of childhood illnesses and child nutrition; and innovative management of chronic disease. An explicit mental health budget might need to be allocated for such activities. Mental health affects progress towards the achievement of several Millennium Development Goals, such as promotion of gender equality and empowerment of women, reduction of child mortality, improvement of maternal health, and reversal of the spread of HIV/AIDS. Mental health awareness needs to be integrated into all aspects of health and social policy, health-system planning, and delivery of primary and secondary general health care.
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                Author and article information

                Contributors
                ziggi.santini@gmail.com
                Journal
                Soc Psychiatry Psychiatr Epidemiol
                Soc Psychiatry Psychiatr Epidemiol
                Social Psychiatry and Psychiatric Epidemiology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0933-7954
                1433-9285
                9 October 2020
                9 October 2020
                2021
                : 56
                : 3
                : 417-428
                Affiliations
                [1 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, The Danish National Institute of Public Health, , University of Southern Denmark, ; Studiestræde 6, 1455 Copenhagen, Denmark
                [2 ]GRID grid.267827.e, ISNI 0000 0001 2292 3111, School of Psychology, , Victoria University of Wellington, ; PO Box 600, Wellington, 6012 New Zealand
                [3 ]GRID grid.5841.8, ISNI 0000 0004 1937 0247, Parc Sanitari Sant Joan de Déu, , Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, ; Dr Antoni Pujadas, 42, 08830 Sant Boi De Llobregat, Barcelona Spain
                [4 ]GRID grid.425902.8, ISNI 0000 0000 9601 989X, ICREA, ; Pg. Lluis Companys 23, Barcelona, Spain
                [5 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Department of Experimental Psychology, , University of Oxford, ; Radcliffe Observatory, Anna Watts Building, Woodstock Rd, Oxford, OX2 6GG UK
                [6 ]GRID grid.5254.6, ISNI 0000 0001 0674 042X, Department of Psychology, , University of Copenhagen, ; Øster Farimagsgade 2A, 1353 Copenhagen, Denmark
                Author information
                http://orcid.org/0000-0002-7318-3181
                Article
                1961
                10.1007/s00127-020-01961-2
                7904560
                33037448
                a2683c46-fed2-4db3-bdc9-7f2d4812727d
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 15 April 2020
                : 23 September 2020
                Funding
                Funded by: Nordea-fonden (DK)
                Funded by: University of Oxford
                Categories
                Original Paper
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2021

                Clinical Psychology & Psychiatry
                social participation,social network,quality of life,depression,aging

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