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      Association Between Perceived Social Support and Depressive Symptoms Among Community-Dwelling Older Chinese Americans

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      , PhD, RN, GNP-BC 1 , , PhD, ANP-BC 2 , , MD, PhD, MPH 3 , , MD, MPH 4
      Gerontology and geriatric medicine
      SAGE Publications
      social support, depressive symptoms, Chinese aging, older immigrants

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          Abstract

          Purpose: This study examined the association between social support and depressive symptoms among U.S. Chinese older adults. Methods: Data were from the Population Study of Chinese Elderly in Chicago (PINE) study. Independent variables were positive and negative perceived social support (PSS). Dependent variable was depressive symptoms. Multinomial logistic regression analyses were performed. Results: A total of participants were 3,157 Chinese older adults with the mean age of 72.8 years (range 60-105 years). After controlling for confounding factors, Chinese older adults with higher positive PSS were 12% (odds ratio [OR] = 0.88, 95% confidence interval [CI] = [0.85, 0.92]) and 18% (OR = 0.82, 95% CI = [0.79, 0.86]) less likely to report mild and moderate-severe depressive symptoms, respectively, compared to reporting minimal depressive symptoms; On the contrary, Chinese older adults with higher negative PSS were 34% (OR = 1.34, 95% CI = [1.24, 1.46]) and 38% (OR = 1.38, 95% CI = [1.26, 1.52]) more likely to report mild and moderate-severe depressive symptoms, respectively. Discussion: The study findings corroborate previous research that social support is significantly associated with depressive symptoms. Our findings reinforce the importance of developing strategies to utilize positive social support and limit negative support in practice for the depressed older adults. Further studies should be conducted to better understand the associations between different dimensions of social support and depression among U.S. Chinese older adults.

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          Most cited references32

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          Supportive interactions, negative interactions, and depressed mood.

          Research on the association between social relationships and emotional functioning has emphasized the health-promoting effects of social support. Yet there is reason to believe that the absence of negative social interactions may be more important for mental health than the presence of supportive interactions. In this investigation we clarify important characteristics concerning the source, the recipient, and the combined influence of support and negativity. Data are presented regarding supportive and negative interactions with spouse, relatives, and friends; regression analyses suggest that negative interactions are more predictive of depressed mood than supportive interactions (specifically with spouse and friends). We also document several specifications suggesting directions for future research on the special importance of interactions in intimate relationships and the synergistic effects of situations in which supportive and negative interactions both occur.
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            Efficacy of peer support interventions for depression: a meta-analysis.

            To assess the efficacy of peer support for reducing symptoms of depression. Medline, PsycINFO, CINAHL and CENTRAL databases were searched for clinical trials published as of April 2010 using Medical Subject Headings and free text terms related to depression and peer support. Two independent reviewers selected randomized controlled trials (RCTs) that compared a peer support intervention for depression to usual care or a psychotherapy control condition. Meta-analyses were conducted to generate pooled standardized mean differences (SMD) in the change in depressive symptoms between study conditions. Seven RCTs of peer support vs. usual care for depression involving 869 participants were identified. Peer support interventions were superior to usual care in reducing depressive symptoms, with a pooled SMD of -0.59 (95% CI, -0.98 to -0.21; P=.002). Seven RCTs with 301 total participants compared peer support to group cognitive behavioral therapy (CBT). There was no statistically significant difference between group CBT and peer interventions, with a pooled SMD of 0.10 (95% CI, -0.20 to 0.39, P=.53). Based on the available evidence, peer support interventions help reduce symptoms of depression. Additional studies are needed to determine effectiveness in primary care and other settings with limited mental health resources. Published by Elsevier Inc.
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              The importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home: a cross sectional study

              Background Little is known of the importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home. The objectives of the present study were to investigate the associations of social support, somatic health problems and socio-economic factors with psychological distress. We also examined changes in the association of somatic health problems and socio-economic factors with psychological distress after adjusting for social support. Methods A random sample of 4,000 persons aged 65 years or more living at home in Oslo was drawn. Questionnaires were sent by post, and the total response was 2,387 (64%). Psychological distress was assessed using Hopkins Symptom Checklist (HSCL-10) and social support with the Oslo-3 Social Support Scale (OSS-3). A principal component analysis (PCA) included all items of social support and psychological distress. Partial correlations were used, while associations were studied by logistic regression. Results After adjusting for socio-demographics and somatic health problems, we reported a statistically significant association between psychological distress and social support: “Number of close friends”, OR 0.61; 95% CI 0.47-0.80; “Concern and interest”, OR 0.68; 95% CI 0.55-0.84. A strong association between lack of social support and psychological distress, irrespective of variables adjusted for, indicated a direct effect. The associations between psychological distress and physical impairments were somewhat reduced when adjusted for social support, particularly for hearing, whereas the associations between somatic diagnoses and psychological distress were more or less eliminated. Income was found to be an independent determinant for psychological distress. Conclusions Lack of social support and somatic health problems were associated with psychological distress in elders. Social support acted as a mediator, implying that the negative effect of somatic health problems, especially hearing, on psychological distress was mediated by low social support. We hypothesize that physical impairments reduced social support, thereby increasing psychological distress to a greater extent than the selected diagnoses. The combination of poor social support, poor somatic health and economic problems may represent a vulnerable situation with respect to the mental health of older persons. Free interventions that highlight social support should be considered in mental health promotion.
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                Author and article information

                Journal
                Gerontol Geriatr Med
                Gerontol Geriatr Med
                GGM
                spggm
                Gerontology and geriatric medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2333-7214
                17 July 2018
                Jan-Dec 2018
                : 4
                : 2333721418778194
                Affiliations
                [1 ]Rutgers, The State University of New Jersey, Newark, NJ, USA
                [2 ]Boston College, Chestnut Hill, MA, USA
                [3 ]Seton Hall University, South Orange, NJ, USA
                [4 ]Rush University Medical Center, Chicago, IL, USA
                Author notes
                [*]Ying-Yu Chao, School of Nursing, Rutgers, The State University of New Jersey, Ackerson Hall, 180 University Avenue, Newark, NJ 07102-1803, USA. Email: yingyu.chao@ 123456sn.rutgers.edu
                Article
                10.1177_2333721418778194
                10.1177/2333721418778194
                6050614
                d013daa0-bcb2-4693-a822-be4ad61dbb16
                © 2018 The Author(s)

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 16 January 2017
                : 23 February 2018
                : 4 January 2018
                Categories
                PINE Study - Psychological Wellbeing
                Custom metadata
                January-December 2018

                social support,depressive symptoms,chinese aging,older immigrants

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