Week 8-How do our relationships affect our health? Flashcards
What did Taylor (2014) say about relationships?
“People need other people. True independence - for everyone, well, or ill - is rooted in social connection; without this, it is mere isolation and loneliness. This
deep need for connectedness is insufficiently acknowledged throughout the whole of our society.” (importance of relationships for health and wellbeing)
What do we mean by personal
relationships?
Complex, but fall into some broad categories:
1. Couple: Loving relationship between two people e.g. Spouses, civil partners, cohabitors, non-cohabiting couples
- Family: People who are related and/or considered to be family e.g. Parents, children, siblings (lots of literature on family of choice rather than family born into, and the impact on wellbeing and health)
- Social: Wider social relationships e.g. Friends, colleagues, acquaintances (these differ based on motivation and level of commitment)
What are the Structural characteristics of social relationships?
■ In 1950s, researchers developed concept of ‘social networks’ (area of research still going strong today).
Structural characteristics of social relationships:
– Network range and size (may just be a geographical area or demographics)
– Density (how many people in this type of category?)
– Boundedness (are there any particular bounds within the structural characteristics?)
– Homogeneity (how similar?)
– Frequency and forms of contact (e.g., telephone befrienders)
– Duration of relationship
How could you measure social
networks?
Identify what components are relevant for
your particular line of enquiry e.g:
– ‘Who do you send a Christmas card to?’
(Hill & Dunbar, 2003) (looked at 50 families and found 3000 individual interactions between receiving and giving a christmas card to determine the social network creating the Dunbar measure (number of maintained meaningful relationships approx 50). (issues: religion, cards aren’t used as much not representative of younger people, what category of relationship do they fall into).
– Social network diagrams pre/post
(Nilsen et al 2018; Soulsby, 2011)
- How useful is it to only consider social network characteristics of social relationships i.e. number of people, frequency of contact?
- How full a picture does it provide?
- What does it miss? (the depth of the relationships e.g., best friend, to acquaintance. It’s is also temporally contextualised i.e., changes)
What do we mean by social support?
■ Broadly, the existence of personal relationships and availability of their supportive resources
■ Tells us something about relationship quality
Different forms of support:
– Informational (base level e.g., what’s the weather like today?)
– Emotional (shoulder to cry on, sharing experiences and being validated)
– Instrumental (or tangible, practical) (lending something e.g., a book)
– Appraisal (evaluating the information and being communicative and honest)
-Social network diagrams misses these forms of support
How could we measure social
support?
■ Consider content of support (the type)
■ Consider sources of support
– Formal (healthcare) vs. Informal (friends)
■ Direction of exchange
– Receipt (receive) vs. conveyance (give)
■ Evaluation of support
– perceived (unbalanced) vs. ideal vs. received (too much)
What do we mean by social interaction?
■ Or social connectedness or integration
■ Our activities with members of the social network
Can take many forms:
1. Informal – frequency of telephone and face-to-face contact with closer familial relations and friends.
- Formal – engaging in specific leisure activities, volunteer work, religious participation.
Social relationships and health:
What are 2 Early theoretical orientations?
- John Bowlby (attachment theory, identified the role of environment in childhood and the universal need to form close relationships with our caregivers in infancy where if failure to meet, resulted in severe consequences in health and wellbeing).
- Emile Durkheim (contributed to social integration and cohesion, and how this can impact our own likelihood of death i.e., mortality and suicide).
What is the relationship between
social relationships and health?
■ Growing interest in how SR affect health from late 1970s onwards
– Epidemiologists proposed that social integration was important for health and was protective (e.g. Cassel, 1976; Cobb, 1976).
– Close, supportive relationships predict lower morbidity (disease) and mortality (death) (Berkman & Syme, 1979; House et al., 1998).
■ But, early methods made it difficult to determine causality (i.e., was it being in social relationships led to being disease-free, or did being disease-free lead to having more friends?)
-Looked at relationships following death (did it look like a good relationship yet was actually bad?)
– Over time, greater number of prospective mortality studies and more experimental studies with humans and animals.
What’s the evidence for personal relationships and health?
■ Robust evidence that they have important
causal effects on health.
■ Presence of adequate personal relationships associated with ~50% lower mortality risk across age, gender any disease etc., (e.g. Holt-Lunstad et al., 2010).
■ The value of a taking a lifecourse approach
– Developmental health trajectories and
personal relationships (or ‘social convoys’)
intertwine over long periods to make up
the individual life course (Elder et al. 2003).
What is the link between Personal Relationships & Psychological Wellbeing?
■ Social relationships fosters psychological wellbeing (e.g. Travis et al., 2004).
– Low social support associated with the onset and relapse of depression
– Low social connection predicts greater anxiety, lower mood, increased risk of suicide (reflects Durkheim’s ideas)
– Bidirectional (i.e., they both influence each other) - mental health shapes the formation and quality of social relationships across life course
What is the link between Personal Relationships & Health Behaviour?
■ Linked to a range of health behaviours e.g. health screening, alcohol use, smoking, diet
■ Potential value for interventions? (targetting whole group to benefit one or two of them)
■ Link between relationships and health behaviours changes across the lifespan
– Rapid expansion of social network in childhood and adolescence
– Peers single biggest social factor in predicting adolescent health behaviour
– In adulthood, it’s romantic partners
What is the Transactional nature of
relationships?
■ Social relationships are transactional
■ So, what is the role of provision of social
support for health?
– Supporting others may protect health
through fostering personal control, sustaining a sense of self-worth, maintaining network ties (e.g. Brown et al.,
2003).
■ How important is reciprocity for health
benefits?
– What about over-benefitted vs. under-benefitted relationships
Is there a ‘darker side’ to
relationships?
■ Growing volume of research on social isolation (physical) and loneliness (mental)
■ Are all of your relationships rosy?
■ Personal relationships as a source of stress (e.g. Rook, 1992)
– Received much less attention than the supportive aspects
– Double-edged nature of social ties, as a source of support and as a source of conflict, stress and worry (especially if obligated)
– Negative social interactions are more strongly associated with psychological wellbeing than positive social interactions (e.g., Ingersoll-Dayton et al., 1997)
-Also what about the balance of positive and negative relationships? (what is the impact on well-being for being in more negative social relationships>positive? or what about when it’s 50/50?)
What is the impact of Relationship Loss on Health?
■ Bereavement research demonstrates health impact of relationship losses
– Increased psychological distress following
bereavement (e.g. Soulsby & Bennett, 2012)
– Impacts physical health, particularly later life (e.g. Bennett, 2004) (rare for wellbeing to return to normal stage as it is long and sustained)
– Suppressed immune function (more likely to become ill), particularly cellular immunity (Berkman et al., 2000; Richardson et al., 2015)
-Are these impacts more intense based off the closeness of the relationship loss? or is it the same?
