Sherbourne C D
Behavioral Sciences Department, RAND Corporation, Santa Monica, CA 90406.
Soc Sci Med. 1988;27(12):1393-400. doi: 10.1016/0277-9536(88)90205-5.
This study examined the role of social supports and life stress events in use of mental health services. Data were derived from a 3-5 year longitudinal study of a general population of adults (ages 14 and older) enrolled in the RAND Health Insurance Experiment. The sample used in this analyses included those enrollees who participated for a full year in the second (N = 1979) and third (N = 2601) years of the experiment. Included were 4580 person-years of data. Statistical methods used probit regression models which controlled for a number of covariates including insurance plan, site, sociodemographic variables, physical and mental health. Results supported the following conclusions: (1) the more life events experienced, the more likely one is to use mental health services, (2) chronic types of life events are more important than acute events in predicting use of mental health services, (3) when defined as social contacts, social support does not predict use; however, when defined as social resources, the more support one has the less likely is one to use mental health services, and (4) neither social contacts nor social resources buffer the impact of life stress events on use of services.
本研究调查了社会支持和生活应激事件在心理健康服务使用中的作用。数据来源于对参加兰德健康保险实验的成年普通人群（14岁及以上）进行的为期3至5年的纵向研究。本分析中使用的样本包括那些在实验的第二年（N = 1979）和第三年（N = 2601）完整参与一年的参与者。共有4580人年的数据。统计方法采用了概率单位回归模型，该模型控制了包括保险计划、地点、社会人口统计学变量、身心健康在内的多个协变量。结果支持以下结论：（1）经历的生活事件越多，使用心理健康服务的可能性就越大；（2）在预测心理健康服务的使用方面，慢性生活事件比急性事件更重要；（3）当社会支持被定义为社会交往时，它并不能预测服务的使用；然而，当被定义为社会资源时，一个人拥有的支持越多，使用心理健康服务的可能性就越小；（4）社会交往和社会资源都不能缓冲生活应激事件对服务使用的影响。
