Kawachi I, Berkman L F
The Department of Health and Social Behavior, Harvard Center for Society and Health, 677 Huntington Avenue, Boston, MA 02115, USA.
J Urban Health. 2001 Sep;78(3):458-67. doi: 10.1093/jurban/78.3.458.
It is generally agreed that social ties play a beneficial role in the maintenance of psychological well-being. In this targeted review, we highlight four sets of insights that emerge from the literature on social ties and mental health outcomes (defined as stress reactions, psychological well-being, and psychological distress, including depressive symptoms and anxiety). First, the pathways by which social networks and social supports influence mental health can be described by two alternative (although not mutually exclusive) causal models-the main effect model and the stress-buffering model. Second, the protective effects of social ties on mental health are not uniform across groups in society. Gender differences in support derived from social network participation may partly account for the higher prevalence of psychological distress among women compared to men. Social connections may paradoxically increase levels of mental illness symptoms among women with low resources, especially if such connections entail role strain associated with obligations to provide social support to others. Third, egocentric networks are nested within a broader structure of social relationships. The notion of social capital embraces the embeddedness of individual social ties within the broader social structure. Fourth, despite some successes reported in social support interventions to enhance mental health, further work is needed to deepen our understanding of the design, timing, and dose of interventions that work, as well as the characteristics of individuals who benefit the most.
人们普遍认为,社会关系在维持心理健康方面发挥着有益作用。在本次有针对性的综述中,我们强调了从关于社会关系和心理健康结果(定义为压力反应、心理健康和心理困扰,包括抑郁症状和焦虑)的文献中得出的四组见解。第一,社交网络和社会支持影响心理健康的途径可以用两种替代(尽管并非相互排斥)的因果模型来描述——主效应模型和压力缓冲模型。第二,社会关系对心理健康的保护作用在社会群体中并不一致。社会网络参与所获得的支持中的性别差异可能部分解释了女性比男性心理困扰患病率更高的原因。对于资源匮乏的女性,社会联系可能反常地增加精神疾病症状的水平,特别是如果这种联系带来与向他人提供社会支持的义务相关的角色压力。第三,自我中心网络嵌套在更广泛的社会关系结构中。社会资本的概念包含了个体社会关系在更广泛社会结构中的嵌入性。第四,尽管在增强心理健康的社会支持干预方面报告了一些成功案例,但仍需要进一步开展工作,以加深我们对有效干预措施的设计、时机和剂量以及受益最大的个体特征的理解。