Stansfeld S A, Fuhrer R, Shipley M J
Department of Epidemiology and Public Health, University College London Medical School.
Psychol Med. 1998 Jul;28(4):881-92. doi: 10.1017/s0033291798006746.
Few studies have examined prospectively both the direct and buffering effects of types of social support and social networks on mental health. This paper reports longitudinal associations between types of social support and psychiatric morbidity from the Whitehall II study.
Social support was measured by the Close Persons Questionnaire and psychiatric morbidity by the General Health Questionnaire at baseline (1985-1988) and at first follow-up (1989) in 7697 male and female London-based civil servants aged 35-55 years at baseline. The cohort was followed up and baseline measures were used to predict psychiatric disorder measured by the General Health Questionnaire at second follow-up (1991-1993).
Longitudinal analyses showed that low confiding/emotional support in men and high negative aspects of close relationships in men and women were associated with greater risk of psychiatric morbidity even after adjustment for baseline General Health Questionnaire score. There was no evidence of a buffering effect among men or women who experienced life events or chronic stressors. Controlling for a personality measure of hostility did not affect the observed relations.
The present findings illustrate that different types of support are risk factors for psychological distress and that they operate in different ways for men and women. Direct effects of emotional support are predictive of good mental health in men and negative aspects of close relations predict poor mental health in both men and women. Emotional support is predictive of good mental health in women whereas, confiding alone is not.
很少有研究前瞻性地考察社会支持类型和社会网络对心理健康的直接影响和缓冲作用。本文报告了怀特霍尔二世研究中社会支持类型与精神疾病发病率之间的纵向关联。
在基线期(1985 - 1988年)和首次随访期(1989年),使用亲密关系问卷测量社会支持,使用一般健康问卷测量精神疾病发病率,研究对象为7697名年龄在35 - 55岁、以伦敦为基地的男女公务员。对该队列进行随访,并使用基线测量结果预测第二次随访期(1991 - 1993年)通过一般健康问卷测量的精神疾病。
纵向分析表明,即使在对基线一般健康问卷得分进行调整之后,男性低倾诉/情感支持以及男性和女性亲密关系中的高消极方面与更高的精神疾病发病风险相关。没有证据表明经历生活事件或慢性应激源的男性或女性存在缓冲效应。控制敌意人格测量指标并不影响观察到的关系。
目前的研究结果表明,不同类型的支持是心理困扰的风险因素,并且它们在男性和女性中以不同方式起作用。情感支持的直接作用可预测男性良好的心理健康,而亲密关系的消极方面可预测男性和女性较差的心理健康。情感支持可预测女性良好的心理健康,而单独的倾诉则不然。