SOCIAL CONNECTEDNESS

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SOCIAL CONNECTEDNESS HEALTH
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Help me if you can Im feeling down I do
appreciate your being round.
Lennon McCartney, 1965
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DISCLAIMER
Some say

• Im too cynical
• I make it too complex
• I make it too simple
• Im just wrong

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QUESTIONS

• What types of relationship constructs matter for
  health?

• How do they influence health?

• Is it really personality?

• Can our social environment be destructive to our
  health?

• Is marriage a special case?

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What kinds of relationship constructs matter for
health?
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Social Integration--Participation in a
broad range of social relationships
Social Support--Resources provided by others
in the face of adversity material, informational
, emotional aid

• Negative Social Relationships--conflicts, loss,
  isolation, betrayal, loneliness

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How do relationships influence health?
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Modify the Stress Response--Stress Buffering
Hypothesis
STRESS
Cohen Wills, 1985
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Modify the Stress Response--Partial Stress
Buffering
STRESS
Cohen Wills, 1985
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Acts Directly--Main Effect Hypothesis
STRESS
Cohen Wills, 1985
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Social Support, Social Integration and Negative
Relationships
Influence Health through Different Mechanisms!
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Quote from famous Pittsburgh Native
When I got my first TV set I stopped caring about
relationships with other people.
Andy Warhol
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MEASURES OF SOCIAL INTEGRATION

• Social roles
• Participation
• Perception
• Complex

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Social Integration
Social Integration Acts Directly
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Psychological Mediators

• Sense of Identity

Meaning and Purpose to Life
SOCIAL INTEGRATION
Affect Regulation
Expectation for Behavior of Others
(predictability)
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Health Behavior Mediators
Social Control Encourages Healthy Life Style
SOCIAL INTEGRATION
Motivation to Care for Oneself
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Biologic Mediators
Affect Regulation
SNS, HPA Regulation
SOCIAL INTEGRATION
Maintain Biologic Rhythms
Regular Interaction
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Prospective Studies Find SI Predicts Better Health
Healthy at Baseline
Morbidity Mortality
6 months 18 years
Social Integration At Baseline
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SOCIALLY INTEGRATED PEOPLE

• Live longer (5-18 yr follow-ups)
• Less coronary heart disease
• Less stroke
• More likely to survive cancer
• Fewer functional limitations (elderly)
• Less Institutionalization (elderly)

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BERKMAN SYME SI INDEX

• Marital status (x 4)
• Friends and relatives (x 4)
• Group membership (x 2)
• Church membership (x 1)

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Berkman Syme Am J Epid 1979
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Social Isolation and Mortality
RELATIVE RISK
House, Landis et al. (1988) Science
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Pittsburgh Common Cold Study N276 3 Years
VIRUS
6 Day Quarantine
Social Network Diversity
Clinical Colds
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SOCIAL ROLES
Spouse/partner Parent Child Child-in-law Close
relative
Close friend Neighbor Worker Student Church
member Group member/ volunteer
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Social Roles and Colds
Cohen et al. JAMA 1997
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New Scientist 6/28/97
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• Does a
• spontaneous indicator of important social
  relationships predict longevity?

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Longevity of Famous (DEAD) Psychologists

• 96- psychologists included in series
• A History of Psychology in Autobiography

• Average age 65 when autobio written

• Computerized text counts of use of social role
  terms

Pressman Cohen, 2007
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Examples of Psychologists

• Allport
• Boring
• Broadbent
• Cattell
• Eysenck
• Guilford
• Hebb
• Helson

• Hilgard
• Murray
• Newcomb
• Osgood
• Simon
• Skinner
• Terman
• Tolman

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• COVARIATES
• Demographic Controls
• Date of birth
• Sex
• Age at autobio writing

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Examples of Root Words from Social Ties
Dictionary (53 roots103 terms)

• Aunt
• Boyfriend
• Brother
• Churchgoer
• Club
• Colleague
• Cousin
• Dad
• Daughter

• Employee
• Father
• Fellow
• Fiancé
• Friend
• Girlfriend
• Grandchild
• Grandmother
• Husband

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SNI Social Roles Longevity in Psychologists
Psychosomatic Medicine, 2007
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Marriage and the Substitutability of Social Roles
You can substitute one role for another

• ALAMEDA COUNTY
• All of the social roles (marriage, friend,
  neighbor, social group, religious group)
  predicted mortality
• MIND-BODY COLD STUDY
• Marriage, group memberships, volunteers all
  predict lower cortisol

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Social Support
Social Support Acts as a Stress-Buffer
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We all need someone we can lean onand if you
want to, you can lean on me.
Rolling Stones
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How Could Stress Get Under the Skin?
Poor Health Practices
Poor Adherence
Stress Hormones
STRESS
Immune Function
Cardiovascular Function
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How Could Social Support Protect You?

• Provides Coping Resources
• Emotional
• Informational
• Material

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ALTERS MEANING
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PROBLEM-FOCUSED COPING
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EMOTION-FOCUSED COPING
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STRESS-BUFFERING
Measures

• Perceived availability
• Received

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PERCEIVED SOCIAL SUPPORT THE STRESS-BUFFERING
HYPOTHESIS TYPICAL QUESTIONS

• Is there someone you can talk to about intimate
  problems?
• Is there someone who will loan you money when
  you are in need?

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Emotional support (but not SI) interacts with
life events 7-yr mortality follow-up of Swedish
men
Rosengren et al., BMJ, 1993
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Job Strain, Emotional Support and Risk for
Mortality (6-7 yrs.) in Elderly Swedish Men
Falk et al., Am J Public Health, 1992, 82,
1136-139.
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Dependent variables Concanavalin A (Con
A) Phytohemaglutinin (PHA)
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AFFILIATION INDEX
time grooming time in close proximity
time body contact
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Stress, Affiliation and Immune Response(Prolifera
tion to ConA)
Cohen et al. Psych Sci 1992
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Are the effects we attribute to the social
environment really just PERSONALITY?
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Can Personality Explain Stress-Buffering?

• Buffering effects are unaffected by
• Social anxiety
• Social competence
• Self-disclosure

Cohen, Sherrod Clark JPSP (1986)
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Extraversion and Susceptibility to the Common Cold
OR2.61
OR1.00
JAMA (Cohen et al., 1997)
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Rates of Colds by Sociability
Cohen et al. (Psychological Science, 2003)
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Can our social environments be destructive to our
health?
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Destructive with Intent

• Social conflict
• Betrayal
• Exploitation
• Hostility and aggression

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Destructive without Intent

• Promote negative behaviors
• Clumsy or miscarried support
• Stress transmission
• Exposure to infectious agents

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Social Conflict The Common Cold
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Pittsburgh Common Cold Study N276 3 Years
VIRUS
6 Day Quarantine
Psychological Stress
Clinical Colds
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Health Psychology (1998)
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All the lonely peopleWhere do they all belong?
Eleanor Rigby/ Beatles
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Loneliness and AB response to A/New Caledonia
Immunization
Ab titers adjusted for baseline
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Marriage as a Special Case
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Marriage As A Special Case

• Main Effect
• Intimacy, companionship
• Stress-Buffer
• Mutual support, financial advantage
• Negative Interactions
• Conflict, betrayal

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MARITAL STATUS HEALTH

• Overwhelming evidence that married people live
  longer, and are healthier (more for men than
  women)

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U.S. 1989 National Health InterviewMen Women
19-85 (N80,018)8 Yr Mortality Date
Kaplan Kronick, JECH, 2006
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Is it marriage of self-selection into marriage?

• Longitudinal Studies with Repeated Assessments of
  Marital Status
• It is Self-selection
• (1,077 Termans TermitesTucker et al. Health
  Psychology, 1996)
• It is NOT self-selection
• (7,735 British Men Erahim et al. AJE, 1995)

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DOES MARITAL QUALITY MATTER?
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15-year Follow-Up of 2,502 Men and Women in
Kaiser Permanente Baseline Collected 1970-1971

• Baseline Assessment of marriage Marital quality,
  equality in decision making, and companionship
• For married women equality in decision making
  and companionship in marriage are protective
  against death.
• For married men none of the marriage
  characteristics predicted health outcomes.

Hibbard Pope, Soc Sci Med, 1993
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Subclinical CAD in Postmenopausal Women by
Marital Satisfaction

Gallo et al. (2003) Psychosomatic Medicine
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Odds of Women Developing Metabolic Syndrome at
3-Yr Follow-up



Adjusted for age, baseline metabolic syndrome
status, and duration of follow-up. p. lt 05 p lt
.01
Troxel et al. (2005). Archives of Internal
Medicine
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QUESTIONS and ANSWERS

• What types of relationship constructs matter for
  health?
• Many network, perceived, and personality.

• How do they influence health?
• Through both main and stress- buffering
• and acting as stressors.

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• Is it really personality?
• There is overlap, but independent effects do
  exist.

• Can our social environment be destructive to our
  health?
• YES, social conflicts, isolation
  loneliness

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Dr. Cohen says
A friend in need is a friend indeed.
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Winter, spring, summer, or fall, all you have to
do is call and I'll be there, yeah, yeah, yeah.
You've got a friend.
Lyrics by Carole King
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THE END