Social Support underlying BioPsychoSocial with reference to Interventions

Question 1

The Biopsychosocial Model

Answer 1

Hollistic View

Symptoms and disease explained by a range of factors

Psychological, social and cultural and biological processes combine to determine health status

Question 2

Applications of the Biopsychosocial model

Answer 2

Increased social support & coping strategies to improve psychological and physical health.

Health promotion programs to influence alcohol consumption, smoking cessation, improve diet, increase exercise, encourage safer sexual practices;

Stress reduction to benefit endocrine and immune functioning

Reduction of anxiety and depression to facilitate postoperative recovery & wound healing

Question 3

Defining Social Support

Answer 3

Importance of social ties in coping with stress Cassell
& Cobb (1976)

Actual/received versus perceived support.

Question 4

Defining Social Support (Baumeister & Leary, 1995)

Answer 4

Suggested that human beings have an almost universal need to form and maintain at least some degree of interpersonal relationships with other humans

Question 5

Direct & Buffering effects on Health Cohen et al (2000)

Answer 5

Social relationships help to promote health promoting behaviours and neuroendocrine response

This leads to Health Relevant Biological influences which helps prevent Physical disease and Psychiatric disease

Question 6

House et al (1988)

Answer 6

Lack of social relationships constitute a major risk factor for health rivaling the effects of well established health risk factors such as cigarette smoking, obesity & physical activity.

Question 7

Stress & Infection

Answer 7

Adequate immune response means less chance of no illness, however if impaired from lack of social support this could lead to infection.

“Exposure to a virus is necessary but not sufficient condition of developing an infection”.

Question 8

Steptoe (1998)

Answer 8

Those who received lower social support had higher URI infection for no and 1-2 life events.

However, when over 3+ high support had more chance of URI infection

Question 9

Psychosocial Predictors of Disease Progression in HIV/AIDS (Evans et al 1997)

Laserman (2000) also found significant evidence as social support being a significant factor in the progression of HIV

Answer 9

93 HIV positive homosexual men
42 months at 6 month intervals including life event stress
AIDS progression predicted by:
- Higher cumulative stressful life events, lower social support
- Higher serum cortisol

“stressful life events, dysphoric mood and limited social support is more associated with more rapid clinical progression”

Question 10

Turner-Cobb et al (2000)

Chan et al (2013)

Answer 10

Social support and cortisol in Metastatic breast cancer patients.

Compared 3 types of support in all 3 conditions low support produced a higher diurnal mean salivary cortisol

Chan et al, also found that those who received higher negative social support had a flatter diurnal cortisol slope throughout the day along with other negative factors.

Question 11

Psychosocial influences on CHD

Answer 11

Social Isolation
Stress
Low SES

Question 12

Conclusion

Answer 12

Stress, coping & social support closely connected theoretically and practically

Psychosocial factors of social support and coping responses map onto allostatic biomarkers and mechanisms in health and illness

Social support linked to infection, coping and social support.

Question 13

Types of Psychosocial Intervention

Answer 13

Aims to enhance personal relationships and reduce social isolation.

Educational/Informational

CBT - change the behaviour, meditation, feel the fear and do it anyway, finally fourth wave digital interventions.

Biopsychosocial/PNI - Expressive writing & Mindfulness

Question 14

Pennebaker (1986)

Answer 14

A lot of students with eating disorders, found they also had traumatic experiences in the past. Showed if they wrote about their experience it improved their psychological and physical health.

Write for a couple weeks has beneficial effects, however writing for too long can be counterproductive.

Does not have to be handed into someone so no one will read your story, it could go in the bin, therefore people are able to express more freely.

Question 15

Mindfulness Psychological & Biological Benefits

Answer 15

Psychological

Less stressed

More connection with self and others

Greater meaning and purpose of life.

Biological
Blood pressure

Immune system

Stress levels

Telomere Length – shorten as we grow older, help with disease, however when using mindfulness maintains the length.

Question 16

Model of Chronic and Acute Stress

Answer 16

Model of Chronic and Acute Stress
LOW SES serves as chronic stressor
Associated with - NK cell counts and higher plasma IL-6 concentration
Increased cortisol, release fat from central bodily stories which circulates fat.
C Reactive increases in response to inflammation

Also Long term psychosocial factors and genetics can lead to Atherosclerosis
This then leads to Acute Coronary Syndromes which can result in death.

Acute Psychological Stress
Evidence from Lab studies increases biological responses
Characteristics of Acute stress are severe anxiety & witnessing death
Evidence from clinical studies has shown acute stress can lead to acute coronary syndromes

Question 17

Saraneenen et al 2013

Answer 17

A survey of 416 patients was conducted in 2013. A self‐report instrument, Social Support of People with Coronary Heart Disease, was used.

Informational, emotional, functional supports and 16 background variables.

Healthcare professionals should pay extra attention to women, single patients, physically inactive patients, those demonstrating a lower level of education, those with a longer duration of CHD, and respondents without previous acute myocardial infarction. Continuum of care and counselling are important to ensure especially among them.

Question 18

Spalosky (1998)

Answer 18

“With sufficient activation the stress response does not ‘run out’ but can itself become damaging